Zhou. J. (2015) - Human Aspects of IT For The Aged Population

Jia Zhou · Gavriel Salvendy (Eds.
Human Aspects of IT
LNCS 9193
for the Aged Population

Design for Aging
First International Conference, ITAP 2015
Held as Part of HCI International 2015
Los Angeles, CA, USA, August 2–7, 2015, Proceedings, Part I
HCI 2015
International
123
Lecture Notes in Computer Science 9193
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ETH Zurich, Zürich, Switzerland
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Stanford University, Stanford, CA, USA
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Weizmann Institute of Science, Rehovot, Israel
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Indian Institute of Technology, Madras, India
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TU Dortmund University, Dortmund, Germany
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Max Planck Institute for Informatics, Saarbrücken, Germany
More information about this series at http://www.springer.com/series/7409
Jia Zhou Gavriel Salvendy (Eds.)
•
Human Aspects of IT
for the Aged Population
Design for Aging

First International Conference, ITAP 2015
Held as Part of HCI International 2015
Los Angeles, CA, USA, August 2–7, 2015
Proceedings, Part I
123
Editors
Jia Zhou Gavriel Salvendy
Chongqing University Purdue University
Chongqing West Lafayette, IN
P.R. China USA
and
Tsinghua University
Beijing
P.R. China
ISSN 0302-9743 ISSN 1611-3349 (electronic)

Lecture Notes in Computer Science
ISBN 978-3-319-20891-6 ISBN 978-3-319-20892-3 (eBook)
DOI 10.1007/978-3-319-20892-3
Library of Congress Control Number: 2015942475
LNCS Sublibrary: SL3 – Information Systems and Applications, incl. Internet/Web, and HCI
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Foreword
The 17th International Conference on Human-Computer Interaction, HCI International

2015, was held in Los Angeles, CA, USA, during 2–7 August 2015. The event
incorporated the 15 conferences/thematic areas listed on the following page.
A total of 4843 individuals from academia, research institutes, industry, and gov-
ernmental agencies from 73 countries submitted contributions, and 1462 papers and
246 posters have been included in the proceedings. These papers address the latest
research and development efforts and highlight the human aspects of design and use of
computing systems. The papers thoroughly cover the entire field of Human-Computer
Interaction, addressing major advances in knowledge and effective use of computers in
a variety of application areas. The volumes constituting the full 28-volume set of the
conference proceedings are listed on pages VII and VIII.
I would like to thank the Program Board Chairs and the members of the Program
Boards of all thematic areas and affiliated conferences for their contribution to the
highest scientific quality and the overall success of the HCI International 2015
conference.
This conference could not have been possible without the continuous and unwa-
vering support and advice of the founder, Conference General Chair Emeritus and
Conference Scientific Advisor, Prof. Gavriel Salvendy. For their outstanding efforts,
I would like to express my appreciation to the Communications Chair and Editor of
HCI International News, Dr. Abbas Moallem, and the Student Volunteer Chair, Prof.
Kim-Phuong L. Vu. Finally, for their dedicated contribution towards the smooth
organization of HCI International 2015, I would like to express my gratitude to Maria
Pitsoulaki and George Paparoulis, General Chair Assistants.
May 2015 Constantine Stephanidis

General Chair, HCI International 2015
HCI International 2015 Thematic Areas
and Affiliated Conferences
Thematic areas:
• Human-Computer Interaction (HCI 2015)
• Human Interface and the Management of Information (HIMI 2015)
Affiliated conferences:
• 12th International Conference on Engineering Psychology and Cognitive Ergo-
nomics (EPCE 2015)
• 9th International Conference on Universal Access in Human-Computer Interaction
(UAHCI 2015)
• 7th International Conference on Virtual, Augmented and Mixed Reality (VAMR
2015)
• 7th International Conference on Cross-Cultural Design (CCD 2015)
• 7th International Conference on Social Computing and Social Media (SCSM 2015)
• 9th International Conference on Augmented Cognition (AC 2015)
• 6th International Conference on Digital Human Modeling and Applications in
Health, Safety, Ergonomics and Risk Management (DHM 2015)
• 4th International Conference on Design, User Experience and Usability (DUXU
2015)
• 3rd International Conference on Distributed, Ambient and Pervasive Interactions
(DAPI 2015)
• 3rd International Conference on Human Aspects of Information Security, Privacy
and Trust (HAS 2015)
• 2nd International Conference on HCI in Business (HCIB 2015)
• 2nd International Conference on Learning and Collaboration Technologies (LCT
2015)
• 1st International Conference on Human Aspects of IT for the Aged Population
(ITAP 2015)
Conference Proceedings Volumes Full List
1. LNCS 9169, Human-Computer Interaction: Design and Evaluation (Part I), edited
by Masaaki Kurosu
2. LNCS 9170, Human-Computer Interaction: Interaction Technologies (Part II),
edited by Masaaki Kurosu
3. LNCS 9171, Human-Computer Interaction: Users and Contexts (Part III), edited by
Masaaki Kurosu
4. LNCS 9172, Human Interface and the Management of Information: Information
and Knowledge Design (Part I), edited by Sakae Yamamoto
5. LNCS 9173, Human Interface and the Management of Information: Information
and Knowledge in Context (Part II), edited by Sakae Yamamoto
6. LNAI 9174, Engineering Psychology and Cognitive Ergonomics, edited by Don
Harris
7. LNCS 9175, Universal Access in Human-Computer Interaction: Access to Today’s
Technologies (Part I), edited by Margherita Antona and Constantine Stephanidis
8. LNCS 9176, Universal Access in Human-Computer Interaction: Access to Inter-
action (Part II), edited by Margherita Antona and Constantine Stephanidis
9. LNCS 9177, Universal Access in Human-Computer Interaction: Access to
Learning, Health and Well-Being (Part III), edited by Margherita Antona and
Constantine Stephanidis
10. LNCS 9178, Universal Access in Human-Computer Interaction: Access to the
Human Environment and Culture (Part IV), edited by Margherita Antona and
11. LNCS 9179, Virtual, Augmented and Mixed Reality, edited by Randall Shumaker
and Stephanie Lackey
12. LNCS 9180, Cross-Cultural Design: Methods, Practice and Impact (Part I), edited
by P.L. Patrick Rau
13. LNCS 9181, Cross-Cultural Design: Applications in Mobile Interaction, Educa-
tion, Health, Transport and Cultural Heritage (Part II), edited by P.L. Patrick Rau
14. LNCS 9182, Social Computing and Social Media, edited by Gabriele Meiselwitz
15. LNAI 9183, Foundations of Augmented Cognition, edited by Dylan D. Schmorrow
and Cali M. Fidopiastis
16. LNCS 9184, Digital Human Modeling and Applications in Health, Safety, Ergo-
nomics and Risk Management: Human Modeling (Part I), edited by Vincent G.
Duffy
17. LNCS 9185, Digital Human Modeling and Applications in Health, Safety, Ergo-
nomics and Risk Management: Ergonomics and Health (Part II), edited by
Vincent G. Duffy
18. LNCS 9186, Design, User Experience, and Usability: Design Discourse (Part I),
edited by Aaron Marcus
19. LNCS 9187, Design, User Experience, and Usability: Users and Interactions (Part
II), edited by Aaron Marcus
20. LNCS 9188, Design, User Experience, and Usability: Interactive Experience
Design (Part III), edited by Aaron Marcus
Conference Proceedings Volumes Full List IX
21. LNCS 9189, Distributed, Ambient and Pervasive Interactions, edited by Norbert
Streitz and Panos Markopoulos
22. LNCS 9190, Human Aspects of Information Security, Privacy and Trust, edited by
Theo Tryfonas and Ioannis Askoxylakis
23. LNCS 9191, HCI in Business, edited by Fiona Fui-Hoon Nah and Chuan-Hoo Tan
24. LNCS 9192, Learning and Collaboration Technologies, edited by Panayiotis
Zaphiris and Andri Ioannou
25. LNCS 9193, Human Aspects of IT for the Aged Population: Design for Aging
(Part I), edited by Jia Zhou and Gavriel Salvendy
26. LNCS 9194, Human Aspects of IT for the Aged Population: Design for Everyday
Life (Part II), edited by Jia Zhou and Gavriel Salvendy
27. CCIS 528, HCI International 2015 Posters’ Extended Abstracts (Part I), edited by
28. CCIS 529, HCI International 2015 Posters’ Extended Abstracts (Part II), edited by
Human Aspects of IT for the Aged Population
Program Board Chairs: Gavriel Salvendy, USA & P.R. China,

and Jia Zhou, P.R. China
• Jenay Beer, USA • Jean-Claude Marquie, France

• Marc-Eric Bobillier Chaumon, France • Tracy L. Mitzner, USA
• Alan H.S. Chan, Hong Kong • Lisa J. Molnar, USA
• Veena Chattaraman, USA • Karen Renaud, UK
• George Demiris, USA • Marie Sjölinder, Sweden
• Jesús Favela, Mexico • António J.S. Teixeira, Portugal
• Tova Gamliel, Israel • Patrice Terrier, France
• Mohammad Anwar Hossain, • Gregg Vanderheiden, USA
Saudi Arabia • Ying Wang, R.P. China
• Sri Kurniawan, USA • Wan Chul Yoon, Korea
• Jiunn-Woei (Allen) Lian, Taiwan • Martina Ziefle, Germany
• Eugene Loos, The Netherlands
The full list with the Program Board Chairs and the members of the Program Boards of
all thematic areas and affiliated conferences is available online at:
http://www.hci.international/2015/
HCI International 2016
The 18th International Conference on Human-Computer Interaction, HCI International

2016, will be held jointly with the affiliated conferences in Toronto, Canada, at the
Westin Harbour Castle Hotel, 17–22 July 2016. It will cover a broad spectrum
of themes related to Human-Computer Interaction, including theoretical issues,
methods, tools, processes, and case studies in HCI design, as well as novel interaction
techniques, interfaces, and applications. The proceedings will be published by
Springer. More information will be available on the conference website:
http://2016.hci.international/.
General Chair
Prof. Constantine Stephanidis
University of Crete and ICS-FORTH
Heraklion, Crete, Greece
Email: [email protected]
http://2016.hci.international/
Contents – Part I
HCI Design and Evaluation Methods for the Elderly
The Benefits of Involving Older People in the Design Process . . . . . . . . . . . 3

Britt Östlund
Emotions Identification to Measure User Experience Using Brain Biometric

Signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Ivan Carrillo, Victoria Meza-Kubo, Alberto L. Morán, Gilberto Galindo,
and Eloisa García-Canseco
Adopting Scenario-Based Design to Increase the Acceptance of Technology

Innovations for Older People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Diego Compagna and Florian Kohlbacher
Constructing Third Age eHealth Consumers by Using Personas

from a Cultural Age Perspective . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
Maria Ekström and Eugène Loos
Capturing Older People’s Cognitive Capability Data for Design . . . . . . . . . . 44

Shan Huang and Hua Dong
Designing Tangible Interactions for Aged Users Though Interactive

Technology Prototyping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Wei Liu and Yanrui Qu
Developing a Framework for Effective Communication with Older People . . . 61

Ying Jiang, Hua Dong, and Shu Yuan
Music in the Retiring Life: A Review of Evaluation Methods

and Potential Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Mao Mao, Alan F. Blackwell, and David A. Good
Collecting Old People’s Data for More Accessible Design: A Pilot Study . . . 84
Weining Ning and Hua Dong
Time Reduction Design Method for Cognitive Assist Technology . . . . . . . . . 94

Junji Ohyama, Nana Itoh, Kenji Kurakata, and Ken Sagawa
A Robot of My Own: Participatory Design of Socially Assistive Robots

for Independently Living Older Adults Diagnosed with Depression . . . . . . . . 104
Selma Šabanović, Wan-Ling Chang, Casey C. Bennett, Jennifer A. Piatt,
and David Hakken
XIV Contents – Part I
Universal Design as an Approach to Technology Intervention for Seniors . . . 115

Jon A. Sanford
A Living Lab Method for Innovations to Increase Quality of Life

for Elderly - A Pilot Case . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Isabella Scandurra, Madeleine Blusi, and Rolf Dalin
Talking Faces in Lab and Field Trials: A View on Evaluation Settings

and User Involvement Results of Avatar Based User Interaction Techniques
in Three Ambient Assisted Living Projects . . . . . . . . . . . . . . . . . . . . . . . . . 134
Miroslav Sili, Jan Bobeth, Emanuel Sandner, Sten Hanke,
Stephanie Schwarz, and Christopher Mayer
Gamification and Accessibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

Andreas Stiegler and Gottfried Zimmermann
ICT Use and Acceptance
Evaluating All-Inclusive ICT with Developers, End Users

and Stakeholders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Eleni Chalkia, Evangelos Bekiaris, and R. Ignacio Madrid
Access and Use of ICTs Among the Italian Young Elderly: A Field Study. . . 166
Fausto Colombo and Simone Carlo
Patterns of ICT Use among “Senior Technology Experts”:

The Role of Demographic Variables, Subjective Beliefs and Attitudes . . . . . . 177
Michael Doh, Laura I. Schmidt, Florian Herbolsheimer, Mario Jokisch,
and Hans-Werner Wahl
Why Age Is Not that Important? An Ageing Perspective on Computer

Anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Mireia Fernández-Ardèvol and Loredana Ivan
Values and Ethics in Making Emerging Technologies Work

for Older People . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Caroline Holland
Accessing InterACTion: Ageing with Technologies and the Place

of Access . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Constance Lafontaine and Kim Sawchuk
Review of Empirical Research in Recent Decade About the Use of IT

for Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Yi-Chang Li
Contents – Part I XV
Exploring the Impacts of Age and Usage Experience of e-Service

on User Perceived Web Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
Chien Hsiang Liao
Acceptance of ICTs by Older Adults: A Review of Recent Studies . . . . . . . . 239

Qi Ma, Ke Chen, Alan Hoi Shou Chan, and Pei-Lee Teh
An Appraisal-Based Approach to the Stigma of Walker-Use. . . . . . . . . . . . . 250

Andrew McNeill and Lynne Coventry
Perceptions of Computer System Usefulness: Insights for Design

from Experienced Older Users . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262
Tracy L. Mitzner, Neil Charness, and Wendy A. Rogers
Useful or Easy-to-Use? Knowing What Older People Like about Near Field
Communication Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
Pei-Lee Teh, Pervaiz K. Ahmed, Alan H. S. Chan, Soon-Nyean Cheong,
and Wen-Jiun Yap
Pitfalls when Placing Electricity Pylons - The Influence

of Age on Acceptance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 282
Barbara S. Zaunbrecher, Katrin Arning, Baris Özalay,
Hendrik Natemeyer, and Martina Ziefle
Aging, the Web and Social Media
Usability Evaluation of a Social Networking Site Prototype

for the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Jessica Arfaa and Yuanqiong (Kathy) Wang
ICT Access in Libraries for Elders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307

Amrish Chourasia, Jim Tobias, Steve Githens, Yao Ding,
and Gregg Vanderheiden
Examining the Validity of the Banner Recommendation System . . . . . . . . . . 317

Rong-Fuh Day and Chien-Ying Chou
Conducting Acceptance Tests for Elderly People on the Web:

Using the GPII Preference Set for a Personalized Evaluation . . . . . . . . . . . . 325
Alexander Henka, Andreas Stiegler, Gottfried Zimmermann,
and Thomas Ertl
Older Adults’ Usage of Web Pages: Investigating Effects of Information

Structure on Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Jincheng Huang, Jia Zhou, and Huilin Wang
XVI Contents – Part I
Perceived Barriers for Older Adults’ Shopping Channel Selection Toward

Online Shopping: Comparisons Between Different Business Models . . . . . . . 347
Jiunn-Woei Lian
Processing Speed and Vocabulary are Related to Older Adults’ Internet

Experiences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354
Jennifer Romano Bergstrom, Erica Olmsted-Hawala,
and Wendy A. Rogers
Validation of the Computer Literacy Scale (CLS) . . . . . . . . . . . . . . . . . . . . 365

Michael Sengpiel and Nicole Jochems
Age(ism) in Digital Information Provision: The Case of Online Public

Services for Older Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 376
Maria Sourbati
A Framework for Evaluating the Implementers’ Experience in Making

Existing Products Accessible: The Prosperity4all Approach . . . . . . . . . . . . . 387
Katerina Touliou, Maria Gemou, Till Riedel, Maria Panou,
and Evangelos Bekiaris
The Study of Using Facebook in Taiwan’s Elderly Population—a Case

Study in Learners of the Senior Citizens Academy in a City of Taiwan . . . . . 398
Ming-Wei Wang and Yu-Chin Lin
An Older Person and New Media in Public Discourses: Impossible

Encounters? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 405
Monika Wilińska
Technology Generation and Media Usage in B-2-B Communication:

A Cross-Cultural View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414
Martina Ziefle, Vanessa Cabral, Judith Leckebusch, and Toni Drescher
Patterns for User Interface Adaptations: Towards Runtime Adaptations

for Improving the Usability of Web Forms for Elderly Users . . . . . . . . . . . . 426
Gottfried Zimmermann, Annkristin Stratmann, David Reeß,
and Tobias Glaser
The Elderly and Mobile Devices
Older People’s Attitude Towards Mobile Communication in Everyday Life:

Digital Literacy and Domestication Processes . . . . . . . . . . . . . . . . . . . . . . . 439
Francesca Comunello, Simone Mulargia, Francesca Belotti,
and Mireia Fernández-Ardèvol
Differences in the Adoption of Smartphones Between Middle Aged Adults

and Older Adults in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
Shang Gao, John Krogstie, and Yuhao Yang
Contents – Part I XVII
Ease-of-Use of Tactile Interaction for Novice Older Adults . . . . . . . . . . . . . 463

Lilian Genaro Motti, Nadine Vigouroux, and Philippe Gorce
Age-Related Differences in a Usability Study Measuring Accuracy,

Efficiency, and User Satisfaction in Using Smartphones for Census
Enumeration: Fiction or Reality? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Erica Olmsted-Hawala and Temika Holland
Older Adults and the Appropriation and Disappropriation of Smartphones . . . 484

Natalie Pang, Samantha Vu, Xue Zhang, and Schubert Foo
Abilities to Use Technological Communication Tools in Aging:

Contribution of a Structured Performance-Based Evaluation . . . . . . . . . . . . . 496
Lisa Quillion-Dupré, Emmanuel Monfort, and Vincent Rialle
Elderly and Tablets: Considerations and Suggestions About the Design

of Proper Applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509
Eliseo Sciarretta, Andrea Ingrosso, Valentina Volpi,
Antonio Opromolla, and Roberta Grimaldi
Developing New Gesture Design Mode in Smartphone Use for Elders. . . . . . 519
Ming-Hong Wang, Yu-Chi Chang, Shuo-Fang Liu, and Hsin-Hsi Lai
Research on Interaction Design of Intelligent Mobile Phone for the Elderly

Based on the User Experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528
Minggang Yang and He Huang
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537

Contents – Part II
Health Care Technologies and Services for the Elderly
The Role of Health Status in Older Adults’ Perceptions of the Usefulness

of eHealth Technology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Ryan Best, Dustin J. Souders, Neil Charness, Tracy L. Mitzner,
and Wendy A. Rogers
The Use of Smartwatches for Health Monitoring in Home-Based

Dementia Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Costas Boletsis, Simon McCallum, and Brynjar Fowels Landmark
Lack of Development and Usability Descriptions in Evaluation Reports

on Online Health Information Tools for Older Patients . . . . . . . . . . . . . . . . 27
Sifra Bolle, Julia C.M. van Weert, Ellen M.A. Smets,
and Eugène F. Loos
Older Users’ Rejection of Mobile Health Apps a Case for a Stand-Alone

Device? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38
André Calero Valdez and Martina Ziefle
Delivering Telemonitoring Care to Digitally Disadvantaged Older Adults:

Human-Computer Interaction (HCI) Design Recommendations . . . . . . . . . . . 50
Hongtu Chen and Sue E. Levkoff
Accessibility in Serious Games for Adults Aging with Disability . . . . . . . . . 61

Keiko Gomez-Gurley, Anne Collins McLaughlin,
Maribeth Gandy Coleman, and Jason C. Allaire
How Measuring an Older Person’s Walking Pattern Can Help Keep

Them Mobile: ‘Personalised Healthcare for Mobility’ . . . . . . . . . . . . . . . . . 72
Diana Hodgins and Ian McCarthy
Opportunities for Technology: Translating an Efficacious Intervention

to Improve Medication Adherence Among Older Adults . . . . . . . . . . . . . . . 82
Kathie Insel, Jeannie K. Lee, Gilles O. Einstein, and Daniel G. Morrow
Taiwanese Middle-Aged and Elderly Patients’ Acceptance and Resistance

Toward the Health Cloud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Wen-Tsung Ku and Pi-Jung Hsieh
XX Contents – Part II
Multi-disciplinary Design and In-Home Evaluation of Kinect-Based

Exercise Coaching System for Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Gregorij Kurillo, Ferda Ofli, Jennifer Marcoe, Paul Gorman,
Holly Jimison, Misha Pavel, and Ruzena Bajcsy
Considerations in Evaluating Technologies in Memory Care Units . . . . . . . . 114

Amanda Lazar, Hilaire J. Thompson, and George Demiris
Influence of Mobile ICT on the Adherence of Elderly People with Chronic

Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Alexander Mertens, Peter Rasche, Sabine Theis, Matthias Wille,
Christopher Schlick, and Stefan Becker
Principles for Developing Digital Health Interventions for Prostate Cancer:

A Community-Based Design Approach with African American Men . . . . . . . 134
Otis L. Owens
Evaluation of Complex Distributed Multimodal Applications:

Evaluating a TeleRehabilitation System When It Really Matters . . . . . . . . . . 146
Carlos Pereira, Nuno Almeida, Ana Isabel Martins, Samuel Silva,
Ana Filipa Rosa, Miguel Oliveira e Silva, and António Teixeira
Innovative Technology-Based Healthcare and Support Services for Older

Adults: How and Why Industrial Initiatives Convert to the Living Lab
Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Maribel Pino, Caroline Moget, Samuel Benveniste, Robert Picard,
and Anne-Sophie Rigaud
Developing Radical-Digital Interventions to Tackle Loneliness Amongst

the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
Dhruv Sharma, Lynne Blair, and Stephen Clune
Effects of Using Care Professionals in the Development of Social

Technology for Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
Marie Sjölinder and Isabella Scandurra
More Light! Improving Well-Being for Persons Suffering from Dementia . . . 193
Charlotte A. Sust, Peter Dehoff, Christina Hallwirth-Spörk, Dieter Lang,
and Dieter Lorenz
The Design of Pain Management and Creative Service for Older Adults
with Chronic Disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Wang-Chin Tsai, Chia-Ling Chang, and Hsuan Lin
The Design of Mobile Technology to Support Diabetes Self-management in

Older Adults. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Laura A. Whitlock, Anne Collins McLaughlin, Maurita Harris,
and Jessica Bradshaw
Contents – Part II XXI
Design and Fabricate Neckwear to Improve the Elderly Patients’ Medical

Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Xiaolong Wu, Young Mi Choi, and Maysam Ghovanloo
Home and Work Support
Psychosocial Approach of Skills Obsolescence in Older Workers:

Contribution of Methodological Triangulation. . . . . . . . . . . . . . . . . . . . . . . 237
Florence Cros, Marc-Eric Bobillier Chaumon, and Bruno Cuvillier
HAVAS: The Haptic Audio Visual Sleep Alarm System . . . . . . . . . . . . . . . 247

Ali Danesh, Fedwa Laamarti, and Abdulmotaleb El Saddik
CogniWin – A Virtual Assistance System for Older Adults at Work . . . . . . . 257

Sten Hanke, Hugo Meinedo, David Portugal, Marios Belk,
João Quintas, Eleni Christodoulou, Miroslav Sili, Miguel Sales Dias,
and George Samaras
Developing Mobile Application Design of Virtual Pets for Caring

for the Elderly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
Hsiu Ching Laura Hsieh
Implementing the SimpleC Companion: Lessons Learned from In-Home

Intervention Studies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278
Chantal Kerssens, Renu Kumar, Anne Edith Adams, Camilla C. Knott,
and Wendy A. Rogers
Investigation of Sensitivity of Foot Soles to Vibrational Stimuli:

First Results for Developers of Information Interfaces . . . . . . . . . . . . . . . . . 290
Stefan Lutherdt, Eva Kaiser, Tim Kirchhofer, Philipp Wegerich,
and Hartmut Witte
Robotic Interfaces Design: Avatar and GUI Competing for Older User’s
Attention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300
Angie L. Marin Mejia
An Adaptable AR User Interface to Face the Challenge of Ageing Workers

in Manufacturing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Maura Mengoni, Matteo Iualè, Margherita Peruzzini,
and Michele Germani
Development of Caricature Robots for Interaction with Older Adults . . . . . . . 324

Jeffrey Sebastian, Chih-Yin Tai, Kim Lindholm, and Yeh-Liang Hsu
Computer Input Devices and the Elderly: A Musculoskeletal Disorder

Focus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 333
Alvaro D. Taveira and Sang D. Choi
XXII Contents – Part II
Development of Automatic Speech Recognition Techniques for Elderly

Home Support: Applications and Challenges . . . . . . . . . . . . . . . . . . . . . . . 341
Michel Vacher, Frédéric Aman, Solange Rossato, and François Portet
Aging Working Population: Hearing Impairment a Growing Challenge

for the Working Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354
Verena Wagner and K. Wolfgang Kallus
Smart Environments and AAL
Spatial Modeling Factors in Sensor-Based Ambient Assisted Living

Technologies Designed for Ageing Populations. . . . . . . . . . . . . . . . . . . . . . 367
Dua’a Al-Hajjar, Reem Al Ehaidib, Sarah Al Muhanna,
May Al Sohibani, and Areej Al-Wabil
Modeling the Interaction and Control of Smart Universal Interface

for Persons with Disabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
Shady Aly, Ghassan Kbar, Mohammed Abdullah,
and Ibraheem Al-Sharawy
Signing Off: Predicting Discontinued ICT Usage Among Older Adults

in Assisted and Independent Living: A Survival Analysis. . . . . . . . . . . . . . . 389
Ronald W. Berkowsky, R.V. Rikard, and Shelia R. Cotten
Understanding the Socio-Domestic Activity: A Challenge for the Ambient

Technologies Acceptance in the Case of Homecare Assistance . . . . . . . . . . . 399
Salima Body-Bekkadja, Marc-Eric Bobillier-Chaumon,
Bruno Cuvillier, and Florence Cros
The Wearable Multimodal Monitoring System: A Platform to Study Falls

and Near-Falls in the Real-World . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 412
Tracy Jill Doty, Bret Kellihan, Tzyy-Ping Jung, John K. Zao,
and Irene Litvan
Smart Textiles as Intuitive and Ubiquitous User Interfaces

for Smart Homes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 423
Julian Hildebrandt, Philipp Brauner, and Martina Ziefle
Designing an Indoor Navigation System for Elderly People’s Capabilities . . . 435

Mathias Källström, Sondre Berdal, and Suhas Govind Joshi
Exploring Use Cases of Smart Presence for Retirement Communities . . . . . . 446

Karina R. Liles, Rachel E. Stuck, Allison A. Kacmar, and Jenay M. Beer
A Meta User Interface for Understandable and Predictable Interaction

in AAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 456
Aida Mostafazadeh, Ali Asghar Nazari Shirehjini, and Sara Daraei
Contents – Part II XXIII
Giving Elderly Access to Smart Environments: Providing Adaptive

User Interfaces Based on Web Components, the Universal Remote Console
and the Global Public Inclusive Infrastructure . . . . . . . . . . . . . . . . . . . . . . . 465
Lukas Smirek, Alexander Henka, and Gottfried Zimmermann
Communication, Games and Entertainment
Baby Boomers and Gaze Enabled Gaming . . . . . . . . . . . . . . . . . . . . . . . . . 479

Soussan Djamasbi, Siavash Mortazavi, and Mina Shojaeizadeh
Assessing Older Adults’ Usability Challenges Using Kinect-Based

Exergames . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 488
Christina N. Harrington, Jordan Q. Hartley, Tracy L. Mitzner,
and Wendy A. Rogers
Play for the Elderly - Effect Studies of Playful Technology . . . . . . . . . . . . . 500

Henrik Hautop Lund
TwitterIDo: What if My Shopping Bag Could Tell My Friends I’m Out

Shopping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 512
Elena Nazzi and Tomas Sokoler
Designing Cross-Age Interaction Toys for Older Adults and Children . . . . . . 524
Wang-Chin Tsai, Chi-Hsien Hsu, and Kung-Chih Lo
A Slow Game Design for Elderly with Their Family and Friends . . . . . . . . . 533
Yi-Sin Wu and Teng-Wen Chang
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541

HCI Design and Evaluation Methods
for the Elderly
The Benefits of Involving Older People
in the Design Process
Britt Östlund(&)
Royal Institute of Technology, Stockholm, Sweden

[email protected]
Abstract. The more experience we get of involving older people in innovation

and design processes, the more we recognize the benefits of having to do with
life experience as input to the development of digital products and services.
Heterogeneity raises personalization as a key component in design. This paper
argues that old people are an asset in innovation processes, which is illustrated
by projects conducted in Sweden from 1992 to 2014. The aim is to present how
older people contribute to the development and what hinders them. The goal of
these projects was to promote participation of older people during the design
process but to varying degrees depending on the question. Different degrees of
participation and involvement are discussed based on the “participation ladder”,
on an idea of Arnstein from 1969 and on conclusions from innovation research.
Keywords: Life experiences Participative design Older innovators
1 Introduction
Aged, older, elderly – what do we call those who have reached old age? Depending on
our understanding of old age it makes a difference when designing for and with old
people. The problem is that aging and later life is still too little problematized compared
with the technology being tested [1, 2]. While technologies has shifted over the years
from easy-to-use interfaces, GPS support and alarms to robotics and systems for
monitoring, the image of old people remains more or less the same. According to
stereotypes, old people are socially isolated and lonely, and they experience physical
and social losses that are to be compensated for by cleverly designed technologies.
The purpose of this paper is to add leverage why involvement of older users in
design is beneficial. Not only do their contributions result in more accurate solutions
and lead us faster towards the goal, they also make design more innovative and help
preventing prejudices and stereotypes. I will present conclusions from innovation
research to back up these arguments and illustrate various degrees of participation with
examples from Swedish design projects.
1.1 Design for Whom

Looking back at funding schemes for research and development of technology for old
people during the last thirty years, the expectation that technology is the driving force

J. Zhou and G. Salvendy (Eds.): ITAP 2015, Part I, LNCS 9193, pp. 3–14, 2015.
DOI: 10.1007/978-3-319-20892-3_1
4 B. Östlund
for change is pretty obvious. The European Commission, for example, expect the
framework programs to meet a range of presumed needs among the older population,
and to manage the increased costs of health care and social services. Their argument for
the IT society is evident from the beginning – older people have much to gain from an
increase in communication and access to information [3]. Recently, the issue has taken
a turn in the EC. 2012 was proclaimed as the Year for Active Ageing. The purpose was
to highlight reforms for helping people to stay in charge of their own lives for as long
as possible as they age and, where possible, to contribute to the economy and society
[4]. The WHO report before World Health Day 2012 took another step when launching
the call for “Adding life to years” by connecting a longer life with participation and
attitudes [5]. These are steps which make a difference for designers, when trying to
understand how to enhance later life for ageing populations. The step takes us away
from the image of the elderly as a single homogeneous group, whose needs can be
generalized to apply to all elderly people, to a more nuanced picture.
It is true that ageing populations increase. Between 2000 and 2050, the proportion
of the world’s population over 60 years will double from about 11 % to 22 %. The
absolute number of people aged 60 years and over is expected to increase from 605
million to 2 billion over the same period [5]. It is also true that the total fertility rate
2006 was below its replacement level in all OECD countries except Mexico, Turkey,
Iceland and the United States [6]. These numbers probably indicate that there will be
an increase in needs for health care and social services as the consumption of health
care services increase with age. But it does not reflect the fact that the majority of
older populations continue their life course as independent citizens without incor-
porating the role of being a patient or a care receiver as a part of their identity. This is
obvious at least when it comes to Swedish statistics. In Sweden, this group constitutes
less than 20 % of the population over the age of 60. They encompass those receiving
public health care and home help services provided by public or private enterprises
(8.2 %) or those living in nursing homes (7.5 %) [7]. Relatives and friends also
perform services, which in Sweden covers 75 % of the total caring needs [8]. The
question of how to measure this is an ongoing discussion. Municipalities are obliged
to give anyone who needs help. However, the fact that more than 80 % are not
patients or care receivers seem to be a hidden secret. The dominating image of old
people as a homogenous group with similar needs and demands has for a long time
been the prevailing notion. The consequence is that older people become charac-
terized in political documents as well as in media in terms of disease, incompetence,
stagnation and decline [9]. Traditional images of aging based on perceptions of needs
that have been institutionalized for a long time were partially obsolete already in the
1990s. Even today few players have been able to capture the demands of old people
living a modern life [10]. The outcome is that even those in need of home help
services or living in nursing homes are minorities – yet they still define the stereotype
for the entire aging population. These stereotypes are limited because they focus on
aging as a downhill process by physical and social loss and they frame older tech-
nology users as passive recipients of technology. Current design practices for older
persons, therefore, imply a threefold risk. They are likely to generate technology
which is unattractive for older consumers, which provides limited cues for
The Benefits of Involving Older People in the Design Process 5
meaningful activity, and which suppresses the co-creational inputs of older persons to
innovation [11]. The good news is that we are now at the frontier between the old and
new images of aging.
Today, more and more designers experience that these stereotypic images crack
when old people themselves are let into projects as participants. When fictive older
users are replaced by real older users, you quickly discover that this is about a diverse
group of people characterized by heterogeneity. The categorization of older people as a
homogeneous group is quickly replaced by a more individualized approach. In fact,
longitudinal research shows that individual differences increase with age [12]. This
means that forty year olds are more homogenous compared to eighty year olds.
However, the heterogeneity among older people does not mean they do not have
common features. It has been suggested that retirement may be one thing they have in
common as it involves a new social arena with other expectations from themselves and
society. Other common experiences may be that they are among the oldest in the
community and thus have life experiences that younger lack, which has been shown to
influence their priorities including when it comes to new technology. To be treated like
old can also be a shared experience as well as generations of old people may have lived
through the same historical events [13].
1.2 Design to Change Attitudes

Older people have a history of being invisible. Even though the images of old people are
changing it is still relevant to state that they are neglected as users and consumers of new
information and communication technologies [14]. Lay end users is a concept that was
introduced to differentiate between those involved and not involved in the expert dis-
course as a part of the design process [31]. Implicated users is another concept, where
users are defined as “those silent or not present but affected by the action” [15]. These
implicated users consist either of those who are physically present but discursively
constructed and targeted by others, or of those who are physically present but who are
generally ignored or made invisible by those in power. Old people belong to both these
groups. They are definitely present but often as a discursive construct, not as participants.
One reason why it is important to give the elderly more opportunities to express
their own needs and desires is that this is strongly related to influence and visibility.
Designers can thus affect significantly and accelerate the change in attitude to the
elderly. A thought-provoking parallel could be drawn to women’s struggle for power
over the situation. The author Betty Friedan compares the view on women in the 1970s
in the United States with the current view on older people [16]. She discovers that there
are no images of aging she can identify with. When older people are described, it is
always relative to others, especially to those who are active and productive. It’s always
someone else who defines the problems, not the aging man himself with his experience.
This was also the situation for women, whose experiences long lacked a name or an
expression. Friedan describes how experts’ awareness and identification of older
people’s needs and problems are as invisible as when men previously identified
women. The change came when women themselves began to articulate their own
problems and experiences.
6 B. Östlund
One challenge is to reinforce the view of older people as active, involved and
experienced and broaden their roles beyond being patients and care receivers. The shift
from considering users as passive objects of research to giving them a role as active and
pro-active innovators include concepts such as “universal design” and “empowerment”
[17]. These concepts were coined in the context of disability research that paved the
way for a broader, non-discriminatory view but also a deeper understanding of how
design contributes to improved quality of life. Eric von Hippel launched the concept
“lead users” to show that the user is the carrier of the aspects necessary for the
innovation process [18, 19]. This has now been replicated in a number of concepts
related to the aging population and digital development. These include “personaliza-
tion” [20], “social needs” [21], and “the innosumer” [11].
2 Method
Depending on whether one considers users as objects or as subjects, they get different
roles in the design process. Using them as research objects, the designer is seeking
generalizations to be applied in design. As a subject they participate themselves in
design and development. Moreover the domestication of new technologies in people’s
life spaces is far from predictable. The fact is that it is when technology comes into the
user’s hands and is contextualized that its real value turns out [22, 23]. Including user’s
home or daily context takes us closer to reality, meaning discovering unpredictable
aspects and innovative ideas. Depending on what we want to achieve, what steps users
themselves are willing to take or are already taking, their participation will be high or
low. The choice of method is determined by the question, and in turn, the extent to
which we give users the opportunity to participate. Active citizens are in a sense a
prerequisite for the development of society in general, but a conscious choice of
methods provides greater opportunities to go further with projects. When users are
involved in the development of technology, it means that they will be jointly
responsible for the results, they will better understand the consequences and may for
these reasons continue to contribute to improvements.
2.1 How to Make Them Participate

One way to illustrate the degrees of participation is the participation ladder [24]. This is
a ladder developed in the context of housing planning in the US in the 1960s to
illustrate the degree of participation of citizens in the planning process. Today, we can
use this ladder both as a mirror to understand on what step we ourselves are collab-
orating with users and as a framework for different options of participation. See Fig. 1.
The ladder can have many steps. Arnstein split the steps into three categories of
participation. First, complete citizen participation and influence by the citizens perhaps
on their own initiative. An example is if you belong to a group that has initiated a
senior housing to be built. The second step, symbolic participation, includes consul-
tation and information. This is probably the step where most design activities take place
and where we invite people to test prototypes. The lowest level, non-participation,
Fig. 1. The participation ladder on an idea by Arnstein (1969)
requires a pretty passive user. However, this should not be interpreted only in negative
terms. General information to households, for example, is very important at certain
stages. The term manipulation is however what we should avoid since it runs the risk of
violating ethics and human rights.
3 Examples of Design for Various Degrees of Participation
This ladder will illustrate the degree of user participation in relation to the kind of
results obtained in the Swedish design projects presented below. The projects were part
of the Ageing and design program at the Department of Design sciences at Lund
University 2005–2014, except for the project about Home shopping terminals that were
part of the research at The Institute for Tema Research at Linköping University 1992–
1995. The projects were different in their goals and nature but followed the leading
principle to include older participants in every project. Here we worked with five steps
to clarify the choice of methods. The lowest step will not be exemplified since we lack
such project examples (Fig. 2).
3.1 How Can We Get Access to Products and Services We Need?

The first example illustrates older people as co-actors driving the changes they want to
accomplish. In a project initiated by a group of fifteen women, 63–69 years old, the
purpose was to investigate available services in the local neighbourhood directed
8 B. Östlund
Fig. 2. Levels of participation distributed on the idea of the participation ladder (Arnstein 1969)
towards independent older people living at home in the city of Stockholm and the
possibilities of organizing local networks in which they were involved themselves in
the performance of services. The older women noted early on that they lacked access to
adequate services and were particularly critical of the municipal elderly care service:
They realized that it was not the old people’s needs, but rather the service provider’s
priorities which governed the supply of help they could receive. Nor did the com-
mercial market offer the services they wanted to purchase. They were in particular
interested in the access to information and the potential of IT-development including
both hardware and software.
The assessment ran from September 2007 to May 2008 and included working
meetings, focus groups and a workshop on technical design. The workshop was
organized with expertise in industrial design, electronics and construction of computer
systems. Individual examples and ideas were discussed and requirements were speci-
fied. The most important requirement was to keep the power to interpret the needs and
demands within the group.
In summary, the participants came to the conclusion that the services available
today primarily address old people who are vulnerable, ill and chiefly require help with
household matters. The study results suggest the need for the public care sector to
re-evaluate their supply and better assess changes in demand. There is also room for the
development of various forms of services and business models that better match the
needs and demands of independent older people. Access to information was discussed
as necessary to become an active consumer. However, none of these products existed at

that time in the way the older people wished. The phone appeared to be a simple and
accessible way to communicate but was no longer optimal for everything due to
automated, key pressing systems for delivering information, a variety of interfaces and
mobile phones. Access to the Internet was still troublesome for them and they felt
marginalized when they heard on TV that, “The information is available at www. . . .”
announced at television or in papers. The women responded specifically to the fact that
their experience of using technology was not taken advantage of. Neither were they
attracted to use ‘phones for the elderly “because they found that this could be stig-
matizing. They were also disappointed of how phones in general were designed. They
concluded that these products had hardly been tested before they were labelled as being
products for older people.
As a result, they organised a telephone based network to support each other in
various ways in the local neighbourhood. Besides the network this endeavour show that
there is a lack of services demanded by old people and that the nature of these demands
can only be understood from their point of view.
3.2 Will New Technology Based on Existing Habits Increase Acceptance

and Use?
The second example is about older people as experts of their own life situation. In
another project with eleven older users, 57–80 years old, the purpose was to study the
extent to which older people’s lifelong experience of watching television reduced their
uncertainty when faced with new TV-based applications. The project was initiated by a
research group in collaboration with a company: In view AB (later ippi AB). In view
AB provided the project with a patented system for asynchronous communication –
“ippi” – used as a basis for a prototype communication device utilizing the participant’s
television as the primary interface. See Figs. 3 and 4.
Fig. 3. ippiTM Fig. 4. The ippi remote control with wheel

button
10 B. Östlund
The implementation and testing of the system were structured as an iterative design
process based on the necessity to get access to users’ daily context and TV-habits to
understand the potential of the prototype. The implementation included conceptual
development, a six-month test period in the homes of eleven users with usability tests
and interviews, monthly focus groups and information gathered by a backup function
that also provided the users with immediate help with the technology if necessary.
The results show that while the use of TV as a metaphor or platform succeeded in
getting the older users to try out and use the ippi prototype, it did not contribute primarily
to using the ippi on a daily basis during the test period. Rather, participants’ access to a
social context or a social network determined the extent of usage. There was a difference
between what was easy to use in terms of the interface, and what was easy and worth
using in a social everyday context on the other hand. In order to be used, a new product
of this type must add value and that value depends upon integration into daily com-
munication [25]. This is the kind of “sticky information” that von Hippel ascribes to
users and which can be obtained only in relation to the users themselves and their daily
context [26]. The length of the tests at home also was of considerable importance to
understand the role of technology in relation to established routines and habits.
The product is today used in about 25 local communities in Sweden. However,
since the public market for these kinds of products is still quite undeveloped the
company sold the product to Care Communications AB and we do not have infor-
mation about its future.
3.3 What Are the Preferences for Furniture Among Older Consumers?
The third example describes older people contributing with their views in consultations.
A sub study of the PLUS-furniture project conducted 2008–2010 was a laboratory test
where thirty men and women, 57–87 years old, tried out furniture, more precisely to
evaluate properties and characteristics of chairs [27]. The PLUS-furniture project
including seven Swedish furniture design companies aimed at exploring the use of
furniture and activities among the older population. The background was a common
interest in The Swedish Wood and Furniture Industry Association and the Department
of Design Sciences at Lund University to investigate older people’s preferences for
furniture for their own use at home. The demographic trend of a growing elderly
population, many with good economy, was well known. However, there was no
knowledge about their preferences as furniture consumers. The IT-aspect was stressed
both as a part of furniture and as a part of the situation where the furniture is used,
however, it was not discussed in the sub study presented here.
One part of the project was to evaluate furniture on the market. The choice to study
chairs was motivated by the fact that it was the type of furniture most frequently
mentioned in a previous study. Also, chairs are the most frequently used furniture type
and the most common purchase for nursing homes [28]. However, it was the older
individual consumers that were in focus as companies identified them as an unknown
group of customers who do not just represent a growing percentage of the population
but, above all, are more active, healthier and have greater purchasing power than
previously and who do not want products that communicate aging and helplessness.
The study was conducted in a usability laboratory with chairs that the companies
picked out themselves based on their assumptions of what older consumers prefer.
A method for evaluating user satisfaction through structured interviews was used
to highlight participants’ interaction with furniture in a systematic sequence of
human-product interaction. For example, the systematic sequence comprised items
such as looking at, ingress into, sitting in, egress from and moving the chairs.
The results showed that the participants displayed different needs of and wishes for
comfort. The participants shared an appreciation for chairs with properties and char-
acteristics suiting their bodies, homes and desired identities.
The companies integrated part of these results in their design and marketing. To test
a selection of chairs in a laboratory proved to be a relevant match, and answered
questions about sitting, egress and moving the chair. The results however suggest that
the designer should consider the experience of comfort and previous experience with
similar furniture, data which requires access to user context outside the laboratory [27].
3.4 Trying to Impose the Visions of IT-Society on Older Care Receivers

The fourth example show older people being the object for new IT-systems. In a study
conducted between 1992 and 1994, the first home shopping terminals to support elderly
people in Sweden were evaluated with twenty older users, 80–102 years old, living at
home and dependent on the public home help service for daily shopping of groceries.
The purpose was to examine to what extent such a home shopping system could
replace store shopping and how it intervened with the users’ relations with the home
help service. The adventure was initiated by the Municipality of Malmoe, the National
Telecommunications Authority – Televerket and Samhall, a state-owned Swedish
company assigned to provide meaningful work for people with disabilities. More than
800 home shopping terminals were tested among elderly persons dependent on help
with the shopping of daily groceries. The purpose was that they should do the shopping
from home, on their own or together with their personal caregiver from the home help
service. In doing this, the caregiver was supposed to free up time which could be spent
together with the care receiver. At the same time, the municipality would save money.
The time spent and the costs saved were calculated in detail. To pick up the groceries at
the store and delivering them to the homes was done by people employed at Samhall.
On the first page of the main regional newspaper, there was a picture of four men
representing actors involved in this venture assured that “this is the future home helper
for elderly people. The home help service is first out using computer shopping”. They
proudly announced that the home help service were the first at launching “computer
shopping” and thus were supposed to get a first glimpse into the future. Like the
Bangemann report, this venture identified the needs of elderly people as a perfect fit
into IT-development [3].
The result of this venture was described in a dissertation where the importance of
technology in everyday life was studied from the perspective of older people (Östlund
1995). Very few terminals were actually used by the elderly or by their care givers.
The resistance among the elderly people was misinterpreted, the efficiency of the
relationship between the home help service and the elderly care receivers was
12 B. Östlund
misunderstood and the time needed to make the system work miscalculated. The
majority of the elderly that were provided with home shopping terminals did not make
use of them; neither did the home help services because of a range of technical failures.
Being active users in charge of their own lives and with a lifelong experience of
technological change they didn’t find that the home shopping terminals had any
comparative advantage to the existing shopping practice. Consequently, increased
usability, meaning a more usable and appropriate interface would not change the
situation.
The venture ended after two years trials. It was overthrown by another solution
procured by the municipality: a car delivering groceries once or twice a week, picking
up shopping lists and assisting the elderly with carrying in the packages. If this example
will constitute a step towards home shopping on the Internet as we know it today, will
show in a later historical perspective. Nevertheless, it is an example of a technically
driven venture, typical of the early days of IT development. Elderly people were
discovered as a potential target group, or at least as fictive users with, what seems to be,
needs that met the technical possibilities of that time.
4 Conclusions
The projects above illustrate different degrees of user participation and demonstrate the
importance of choosing appropriate methods for what you want to achieve. Obviously,
older participants can contribute to design in various ways. The complete citizen
participation on the upper steps of the ladder brings more options to sustainable
changes compared to the lower steps, of which the designer is more in control. The
advantages of involving older users are first, that they have lifelong experience of
technology use. Second, their experiences include a wide range of technological
changes and technological development. Hence, they are familiar with changes. Third,
the effect of aging makes them more pragmatic compared to when they were younger.
This is a consequence of that they now have to economize their time and energy. They
are willing to learn to use new technology if it is worthwhile but not because it is new.
This experience, combined with the ability to see the big picture is nearly unbeatable.
Some learning lessons from innovation research prove that life experienced people
fit very well into what is needed for successful innovation processes. In this paper, the
examples reflect both innovation processes i.e. driving changes where defining what
kind of IT will be the best support is a part of the project as in the first example, and
design processes where the technological support is already defined but needs to be
designed as in the second and third examples.
Readings of Porter and von Hippel prove that some of their findings and theories
should be worthwhile applying in this field, trying out the benefits of involving old
people in design [18, 19, 29]. The readings of these authors make me draw the con-
clusion that the following factors are among those contributing to successful innovation
processes: high demands and difficult problems that offer resistance but include users
that are patient and experienced. Old people meet these demands since they are
experienced, pragmatic, patient and trustworthy. The latter can of course change over
time if values in society change. On the other hand, dependency and independency
probably effect the relationship to project leaders as well as to care givers. The benefit
of involving older users is, in terms of innovations, especially important when it comes
to their participation on the higher steps of the ladder. They are not, as has been often
referred to, laggards, they are also early adopters if they get the chance [30].
Acknowledgements. The author owe many thanks to Sabina Fabrizi for proof reading the
manuscript.
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Emotions Identification to Measure User
Experience Using Brain Biometric Signals
Ivan Carrillo(&), Victoria Meza-Kubo, Alberto L. Morán,

Gilberto Galindo, and Eloisa García-Canseco
Universidad Autónoma de Baja California, Ensenada, Mexico

{ivan.carrillo,mmeza,alberto.moran,gilberto.galindo.
aldana,eloisa.garcia}@uabc.edu.mx
Abstract. There are different techniques (e.g. direct or indirect observation,

questionnaires, etc.) with which it is possible to estimate user experience. Bio-
metric data obtained with different devices (e.g. EEG, EMG) have been used as a
source to infer user experience. In this work, as part of the construction of an
evaluation model of user experience, we present a preliminary study that seeks to
identify emotions using records of brain electrical activity through the visual-
isation of preset images that stimulate emotions known a priori. The results
include identifying emotions of joy and displeasure through brain activity using
the Emotive device in older adults.
Keywords: Electroencephalogram Emotions Elderly people International

affective image system
1 Introduction
The aging of population and increased incidences of diseases such as the Alzheimer’s
disease have moved researchers to look for alternative non-drug treatments, including
technologies supporting cognition, that seek to maintain the cognitive status of the
elderly through cognitive stimulation [1, 2]. To this end, diverse intelligent environment
applications that seek to promote cognitive stimulation have been proposed [3]. How-
ever, due to the characteristics of this group of users, caused by their decline in their
physical and cognitive skills, it is necessary to assess what is the elderly’s perception
regarding the use, acceptance and adoption of these applications.
In the literature various types of usability and user experience evaluations have been
reported to assess the perception of the elderly regarding the use of technology [4],
however, conducting this kind of assessments may be a difficult task due to the inherent
limitations of the evaluation methods themselves. It is well known that in techniques
based on self-report, participants tend to respond thinking about what the researcher
wants to hear, or tend not to be sincere and “improve” their perception of the results
because they feeled assessed, or because they have forgotten the details of their expe-
rience [5]. Because of this, the results of these evaluations may not be very reliable. In
addition there are additional elements that can affect user experience, including [6]:
context of use, devices, cultural factors, social factors and the user features.

DOI: 10.1007/978-3-319-20892-3_2
16 I. Carrillo et al.
As an alternative to traditional user experience assessment techniques, we propose to

record brain electrical activity of the participant by means of a low-cost electroen-
cephalogram (EEG) device, to infer the user experience in an automated manner; and
this through the design of a baseline EEG reference associated with two basic emotional
states (pleasure-displeasure). The goal is to build a model with which we could identify
emotions using biometrics brain data and based on these determine the user experience.
In this work we present the first results of the process towards building this model.
2 Related Work
In recent years, biometric data have been used to assess the experience of users. For
example, in [7], an assessment is made using the game Half-Life 2 by means of galvanic
skin response, video, questionnaires and electromyography of users. Additionally, in [8]
different physiological data such as galvanic skin response, electrocardiogram, elec-
tromyography of the jaw, and respiration rate are used to measure the user experience in
entertainment technology, specifically using EA Sport video game NHL 2003.
Chai [9] evaluates three mobile phone applications using three self-report ques-
tionnaires to obtain subjective data as well as recording brain activity using EEG of
participants. These data were used to determine the positive and negative states in the
user experience of the applications used. Yao [10] evaluates the user experience of a
cell phone application using the User Experience Questionnaire (UEQ) as well as
physiological data such as brain activity (EEG), galvanic skin response, pulse, heart
rate and respiration rate.
Hakvoort [11] evaluated the user experience of a brain-computer interface
(BCI) game based on the expectation of users. For such assessment, a modified version
of the SUXES method [12] was used. They used an evoked visual response as stimuli,
and an EEG to register physiological data.
In a similar fashion, in this work we propose to design a model that uses brain
biometric data to evaluate the user experience of the elderly during their use of com-
puter applications, and compare these results with those of other more traditional
assessment techniques.
3 The Brain and Emotions
The brain has approximately 100 million neurons and is responsible for processes such
as reasoning and emotions, among others. The brain is divided into two hemispheres,
the left and the right1, which in turn are divided into four lobes2: frontal, parietal,
occipital, and temporal [13] (see Fig. 1).
On the one hand, emotions can be positive or negative. At all times, no matter the
context of the (private or public) situation people experience a range of emotions whether
positive (e.g. joy, gratefulness, sympathy, happiness, love, etc.) or negative (e.g.
1
http://neurocirugiacontemporanea.com.
2
http://www.nlm.nih.gov.
Emotions Identification to Measure User Experience 17
Fig. 1. Hemispheres and brain lobes
displeasure, irritability, disgust, anger, sadness, etc.) [14, 15]. Investigations concerning
emotional state indicate that left prefrontal cerebral activity is associated with positive
facial expressions while viewing joyful films, whereas right prefrontal cerebral activity is
associated with negative facial expressions while viewing unpleasant films [16]. Positive
emotions are associated with the activation of regions of the left hemisphere while neg-
ative emotions relate to the activation of regions of the right hemisphere [16–19].
On the other hand, asymmetry analysis of the power of the alpha wave, is recog-
nized as a useful procedure for the study of emotional reactivity [20]; further, it is
common to find the asymmetries in the frontal region of the brain, which may be
perceived on a subject since childhood [18]. In a study conducted in [21] a spectral
analysis of the electrical activity obtained through an EEG is conducted. In this analysis
it is established that the power of the alpha wave varies depending on the emotion
present (positive or negative emotion). Coan [22] mentions that frontal EEG asym-
metry serves as a moderator in case of emotional activity and also functions as a
mediator if there is an emotional response. Papusek [23], by means of brain activity
EEG records and the Scalar Emotional Abilities Self-Report (SEAS), shows that people
perceive the emotions of others and are able to regulate their own emotions, this by
means of asymmetric changes in the prefrontal cortical regions during social interaction
and emotional stimuli. Also in Papusek [23], other works on EEG and emotional states
are presented, which show the asymmetrical changes that occur in the prefrontal cor-
tical part of the brain during social emotional stimulations [23].
Taking this background into consideration, in the next section a controlled study is
described that seeks (i) to analyze the biometric signals of an electroencephalogram
(EEG) of the participants and (ii) identify patterns in the frequencies of signals and the
activated brain areas according to known a priori stimuli.
4 Methodology
In order to build a model that interprets a set of user experience emotions, we con-
ducted a preliminary study that presents selected images to stimulate known a priori
emotions and registers the EEG response. For the study we used the International
Affective Picture System (IAPS) [24], which establishes a set of standardized images
that are used by researchers in the study of emotions and attention. A subset of the
images proposed in [25], which evoke specific emotions. The following categories of
emotion in images were used: (A) 10 of fear, (B) 10 of joy, (C) 10 of displeasure and
(D) 29 neutral (see Fig. 2).
Fig. 2. Example of selected images from the IAPS catalog
The results of brain activity were studied using spectral analysis of power =
10*log10(µV2/Hz)r2 in the alpha, betha and theta bands, including 15 min of trace clean
of artifacts removed by visual analysis, in the frontal and occipital derivations: (1) AF3,
(2) F7, (3) F3, (4) FC5, (7) O1, (14) AF4, (12) F4, (13) F8, (11) FC6 y (8) O2.
4.1 Participants
Participants were 8 seniors, 2 men and 6 women, aged 60 to 83 years (avg. = 72.3 years,
s.d. = 8.46 years). Inclusion criteria were: aged over 60 years, not having suffered a head
trauma, absence of moderate or severe cognitive problems and absence of visual
problems (i.e. not being able to see well without glasses at a distance of 30–50 cm). All
participants signed an informed consent, the procedures of this study did not represent
any risk to them. To determine that participants did not have cognitive problems, we
applied the Mini Mental State Examination (MMSE).
4.2 Materials
• Device: We used the Emotiv EEG device (See Fig. 3) with which is possible to obtain
and record brain activity through 14 electrodes (AF3, F7, F3, FC5, T7, P7, O1, O2, P8,
T8, FC6, F4, F8, AF4). The electrodes are placed according to the International 10–20
System, which sets the position of the electrodes on the craneal surface corresponding
to cortical areas. The device also has a filter for frequencies from 0.2 to 45 Hz, which
takes 128 samples per second for each channel.
• Software: We used Camtasia Studio to record the facial expressions of each partici-
pant; TestBench software, included with the Emotiv EEG device, to record data from
brain activity with the 14 electrodes; EEGExProc, to display images; and EEGLAB to
process the electroencephalography data [26].
Fig. 3. Device and EEG channel positions
4.3 Reduction, Filtering and Data Analysis

To perform data analysis of the recorded brain activity using the EEGLAB software,
we applied a finite response filter to the impulse for powers above ranges of electrical
brain activity, in order to attenuate all signals with frequencies less than 0.2 Hz and
eliminate various artifacts. Deleted artifacts are generated by eye blinking, lateral eye
movements, muscle activity and others movements [27, 28]. This was corroborated by
visual analysis. Once applied the filter and removed the unnecessary signals and arti-
facts, we proceeded to apply the Fast Fourier Transform, in order to obtain the powers
of the different brain waves (alpha, betha, theta and delta) and to graphically identify
the different brain areas activated depending on the analyzed brain wave.
4.4 Procedure
• Introduction to the study: Firstly, we explained to the elderly the purpose of the
study and the characteristics of the Emotiv EEG device. They were also asked to
sign a consent form.
• Device calibration: For best performance of the device, this was calibrated for each
participant by recognizing facial gestures and the manipulation of a virtual 3D cube
through brain interaction.
• Image presentation: In this stage, each participant was presented with a set of images
according to the proposal in [24]. The images were presented in a sandwiched way:
joy, fear, disgust and neutral for 6 s each, and immediately after, we asked the
participant to indicate what was his/her impression upon seeing the image according
to one of the following categories: joy, fear, disgust and neutral. During this phase,
the brain activity of each participant was recorded by the TestBeanch software.
5 Results
According to the classification verbally reported by each participant, we obtained that

the answers to the selected images to provoke emotions of joy fitted 92 % of the times
(see Fig. 4). Additionally, responses to images of disgust agreed 84 % of the times (see
Fig. 5). In both cases, the images converge to the categories of the established test.
Fig. 4. Joy
Fig. 5. Disgust
Responses to the images selected to evoke fear agreed 49 % (see Fig. 7) of the times,
while for those selected as Neutral their responses corresponded 56 % of the times (see
Fig. 6). As can be seen, the responses in these categories did not reported as expected.
Later, once brain activity data was processed by means of the methods described in
section “Reduction, filtering and analysis”, different EEG frequency spectra were
obtained for each of the bands. The analysis of EEG data was corroborated by an expert
in the area of neuroscience. The asymmetry in the alpha band of subject ADM1 indicates
the possibility of observing through EEG patterns a relationship with the affective state
during the observation of stimulus with emotional valence as a synchronization response
caused in the limbic system and its relation to the frontal structures.
The power of the beta band was more prominent in the dorsolateral frontal of the
left hemisphere, associated to cognitive analysis of observed information, which sug-
gests an interpretation of disgust by the user, coinciding with the stimuli presented in
the activity (see Fig. 9).
Fig. 6. Fear
In the same vein, regarding the analysis of power of the theta band, it is possible to
observe an asymmetry whose greatest value is seen in the right frontal, consistent with
the stimuli in the activity with emotional charge, besides indicating attention by the
elderly in the activity (see Fig. 10).
6 Discussion
From the results obtained from verbal responses for the images in the joy category
92 % of the responses were reported as joy, 6 % as neutral and 2 % as fear (See Fig. 5).
The image shows that participant AD4 expressed that image 45 caused fear to him/her;
in this case the image corresponded to 3 girls smiling, so it could be a coding error by
the participant; while for image 51, which corresponded to an older woman, it was
classified as neutral by participants AD1 and AD6.
In Fig. 6, corresponding to the verbal responses for the images in the disgust
category, it can be observed that over 80 % transmitted emotions of disgust to par-
ticipants, while 10 % were reported as neutral, 3 % as fear and 2 % as joy. Participant
AD3 indicated that image 31, which showed a hand surgery, brought joy to him/her as
s/he was a medical doctor, so that it could be concluded that the activities being
undertaken by participant AD3 as a professional affected his/her answer.
For images of the neutral category, we obtained that 56 % of these were classified
as neutral, 40 % of them caused joy and 2 % were reported as disgusting (see Fig. 7).
Participant AD2 consistently indicated the same disgust response for pictures 4, 24 and
44, in which the same fungus appeared, while participant AD5 responded as neutral for
image 4, as disgust for image 24 and as neutral for image 44. These two participants
were the only ones who gave responses of disgust for the images.
For the fear category, only 49 % of the responses indicated that the images pro-
voked this emotion, 39 % of responses indicated disgust and 10 % of responses were
classified as neutral (see Fig. 8). Of this group of images, image 59, which shows a
skeleton, was the only one that did not caused fear; 40 % of participants responded with
neutral and 30 % responded with disgust. It is important to highlight that participant
Fig. 7. Neutral
AD7 was a special case, as s/he responded that all images caused him/her joy. We
observed that participant AD7 was greatly nervous during the test, which along with a
possible misunderstanding during the explanation of the activity could caused that s/he
always provided the same answer.
Fig. 8. Power spectrum of alpha wave
The analysis conducted of the EEG data is preliminary, as we only obtained power
spectra for each band using the EEG registry of each elderly. This analysis allowed us
to visually identify different brain regions where an activity related to the emotional
stimuli were shown depending on the selected band (See Figs. 8, 9 and 10). These
results can be related to those obtained by the categories of joy (positive emotion) and
disgust (negative emotion). The analysis of EEG records stimulus in order to establish a
better relationship between the categories of images with different power spectra and
the brain areas involved remains pending. This type of analysis will reveal which
elements have to be considered in the design of the model to assess the user experience.
Fig. 9. Power spectrum of beta wave

Fig. 10. Power spectrum of theta wave
7 Conclusions and Future Work
This paper presents preliminary results of our proposal to determine a set of emotions
through brain activity (EEG) records. The results of verbal responses of participants
validated the emotional presence of joy and disgust, especially when the selected
images to evoke these emotions were presented.
In the analysis of the spectra for each subject, asymmetries are seen in the frontal
EEG recording of the elderly, this is related to changes in mood showing joy at left
frontal activation and disgust at right frontal activation, allowing the detection of brain
regions linked to these emotions [20, 29, 30]. The electrophysiological results of this
study confirm the possibility of identifying changes in the affective state (displeasure
vs. joy) during the activity through the biometric signals of the brain obtained with the
eMotiv headset. Our future work includes processing the EEG records by type of
stimulus to make a comparison between what is verbally said by the elderly and what is
registered with the eMotive headset. Additionally, we will conduct an analysis of
variance (ANOVA) to determine significant differences between the types of stimuli
administered to subjects.
Acknowledgements. We acknowledge the support of UABC, specially that in the form of the
Programa de Servicio Social 212, and CONACYT by scholarship number 538130 to first author.
We also acknowledge the elderly participants from Ensenada, B.C., México for their support and
participation in the study.
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Adopting Scenario-Based Design to Increase the
Acceptance of Technology Innovations for Older People
Diego Compagna1 ✉ and Florian Kohlbacher2

( )
1
University Duisburg-Essen, Duisburg, Germany
[email protected]
2
Xi’an Jiaotong-Liverpool University, Suzhou, China
[email protected]
Abstract. This paper describes the strengths and weaknesses of the Scenario-
based Design as a method to achieve a user-centered development of technology
for the elderly. Our assumptions are based on findings from a three-year research
project dedicated to the application of service robotics in a stationary nursing
home. In summary, the increasingly specific nature of the phases during the design
process afford a needs-based technical development, thus providing a good basis
for participatory technical development. Nonetheless, some weak points were
identified during the case study. They are related to the graphic nature of the
scenarios as well as following the users’ notions in each and every case. In
consideration of the difficulties that arose during the use of Scenario-based
Design, we conclude with some suggestion for future applications of this method.
Keywords: Scenario-based design · Participatory technology development ·

Assistive technology for elderly target groups
1 Introduction
Regarding the demographic shift, an increasing number of technological developments

strictly related to the healthcare sector occurred over the past decade. Still an ongoing
trend and a topic of great importance (e.g. the main ICT-Agenda of the European Union:
Horizon 2020), research projects dedicated to the development of technology for the
care-giving sector invited participation. In this regard, we describe the process of ICT
developments for the healthcare sector as promising as well as problematic. Our assump‐
tions are based on findings from a three-year research project, which was funded by the
German Federal Ministry for Education and Research and was conducted in Germany
primarily within the years 2009-2012. The research was dedicated to the application of
service robotics in a stationary nursing home. Due to the sensitivity of the field with its
morally charged context and its characterization as a highly human driven “relational”
work sector, the development was guided in part by participatory methods - i.e. the
development should have been driven completely and without any exception by user’s
needs. Even though the adopted method for mediating the users’ needs and the techno‐
logical feasibility were very helpful and delivered promising results, some weak points
and misleading processes became apparent.

DOI: 10.1007/978-3-319-20892-3_3
Adopting Scenario-Based Design 27
In the case study “Scenario-based Design” [1] was examined as a procedure for a
participatory technology development [2, 3]. Scenario-Based Design (SBD) as an
instrument for participatory technology development – according to the optimistic
descriptions in the literature [4] – at first sight offers significant potential for early inclu‐
sion of future users. The obvious clarity along with the iterative process of coordination
and implementing pilot applications ensure an ideal exchange among users and
designers. Ultimately, this process should allow an optimal balance with regard to the
social desideratum and the technical feasibility. In the course of the above-mentioned
three-year research project, this process is almost complete.
Nonetheless, some weak points were identified during the case study. (A) One is
related to the graphic nature of the scenarios. In some cases, the development follows
an approximated interpretation of a drawing showing the new technology in action,
while at the same time, the user follows an interpretation of the same drawing. As we
show with clear empirical evidence from the case study, this might result in completely
useless development simply because the two primary groups involved in the adjustment
process have two very different ways of imagining the implementation of new tech‐
nology in the social field in question. (B) Another main issue is related to the problem
of always following the users’ notions. As we also will prove with data from the case
study, sometimes this could obviate the development of very innovative solutions due
to lack of imagination on the part of the users, who are usually guided by the technologies
they already know and use. (A) will be discussed in Sect. 3.1, (B) in Sect. 3.2.
2 Characteristics of Scenario Based Design
The basic idea behind SBD is to enable the developer of highly innovative technologies
to imagine the needs and wishes of the target group at stake. The core process of the
method consists in iterative adjustment-loops. The graphical and narrative scenarios
become increasingly detailed, ensuring user-oriented development. SBD is a very useful
method for the inclusion of elderly user target groups in the development of (very)
innovative technologies because of the graphic nature of the scenarios (easy to under‐
stand) as well as the iterative adjustments between the involved groups of developer and
user.
“Like other user-centered approaches, scenario-based design changes the focus of
design work from defining system operations (i.e. functional specification) to describing
how people will use a system to accomplish work tasks and other activities […].
However, unlike approaches that consider human behavior and experience through
formal analysis and modeling of well-specified tasks, scenario-based design is a rela‐
tively lightweight method for envisioning future use possibilities.” [1: 1033].
As scenarios are generated in most cases anyway, it is only important to make them
explicit and write them down. The advantage of scenarios lies in their dynamism and
how easily they can be comprehended, which arise from their development in relation‐
ship to the user and, amongst all those involved in the developmental process, eases
communication about the planned execution and/or implementation of a technological
innovation [5].
28 D. Compagna and F. Kohlbacher
2.1 Scenarios in Scenario Based Design

A scenario contains a sequence of actions and events that lead to a concrete result. The
defining characteristic of a scenario consists in sketching a narrative description of
activities that a user will typically employ in accomplishing a given task. The description
should be detailed enough that design-relevant conclusions can be drawn and later
discussed. Scenarios are usually graphically portrayed, and are accompanied by a series
of individual drawings, each accompanied by short written commentaries which
“narrate” the planned action, as in a comic strip or a storyboard [6].
Generally, scenarios are set from the perspective of the potential user and take into
account the user’s social and emotional background, as well as his or her personal moti‐
vations and goals. The scenarios themselves involve one or more participants interacting
in the form of “personas” with the aid of various instruments in order to achieve a certain
goal. Personas are fictitious participants and/or characters who incorporate the typical
characteristics of a certain group of users, possess a concrete usage pattern, and should
be representative of the majority of actual subsequent users. From the outset, personas
should be designed to minimize the development of an end result that is not actually
possible for a potential user. Therefore, a unique scenario should be developed for each
persona and narrated in the third person [7].
The advantage of scenarios as opposed to use cases lies in how easy they are to
comprehend, even for non-specialists. Moreover, use cases often proceed from a deter‐
mined sequence of actions and reactions between users and a system whose character‐
istics are already relatively certain. While scenarios are concrete, they are nevertheless
incomplete and painted in broad strokes, allowing new perspectives on design to emerge
and preventing any assumed, fixed “best solution” from arising prematurely. Via a
gradual and iterative adjustment of concept and detail, scenarios successfully model the
entire phase of analysis and conception [8].
2.2 The Relevance of the Prototype and Evaluation Phase
It is a fundamental requirement of SBD to make an early evaluation of conceptual ideas,

and to repeat this regularly throughout the design and developmental process. If,
however, user orientation is significant in the application of SBD [5] and design-focused
development is understood from the outset as a social process in which heterogeneous
groups are brought together and come into dialogue via the scenarios [6], it is precisely
the narrative character of the procedure that poses a significant risk:
“Part of the appeal of scenarios is that they are short, fun, and vivid. But when used
uncritically, without proper attention given to data quality and representativeness,
scenarios will be no more expressive of the needs of real users than the musings of
engineers or researchers unaided by a representation of user experience. It is easy to feel
that one has captured a user’s experience because it is represented in a narrative or
storyboard, but these accessible representations can easily be inflated into more than
they really are. We should be careful to distinguish the form that the information is
packaged in from the quality of the content therein. As we attempt to design for broader
and broader classes of users who are less and less like designers themselves, it is critical
that we find a way to pipe stimulating input to designers that faithfully captures users’
needs and problems.” [9: 397f].
An important method for avoiding blundering into this “scenario case” is intensive
and repeated adjustment to users [8: 373]. Whether or not SBD is suitable as a procedure
for participatory technological development is finally determined not by accommodating
the desires of the user – and/or the developer determining the scenario’s technological
feasibility beforehand – in the version of the scenario as it appears “on paper.” It is rather
only trial runs that can provide evidence as to the efficacy of scenarios intended for
participatory technological development [8: 371f].
3 Case Study: The Application of Scenario Based Designs

for the Advancement of Service Robotics
The primary objective of our case study consisted of creating and optimizing a knowl‐
edge transfer between developers and users through the choice and application of suit‐
able procedures. For these requirements, SBD presented itself as the method of choice:
SBD’s descriptive quality and relative openness were characteristics which not only
permitted caregivers and inhabitants of stationary nursing facilities to evaluate planned
usage ahead of time, but also allowed developers to identify technically feasible appli‐
cations.
In each of the two, one-week pilot runs, the use scenarios developed and conceived
on the basis of SBD were generated to provide a successful knowledge transfer between
the users in the nursing facility and the team developing the two robots. A central result
derives in this context from supplementing SBD with “rapid prototyping.” From the
experiences in the project serving as a case study (from which generalizations cannot
yet be drawn), one would have to seriously consider the systematic implementation of
rapid prototyping in the pilot phase for projects using SBD – at least with regards to
certain applications that will be discussed in the next Sect. (3.1).
In the following Sect. (3.2), we will take a step back in the chronology of the project
to discuss some important observations with regard to the application of SBD, which
probably arise due to the particular characteristics of the field of deployment (caregivers
and seniors in need of a stationary nursing facility).
3.1 Prototype and Evaluation Phase - Pilot Use
During the prototype and evaluation phase, it became evident that aside from further
developments in the service robots and the design of the user interface, elaborations were
also necessary with regards to the interaction concept, as well as the screen design for the
respective control surfaces of the robots in use; these were often – as far as possible –
carried out “on site.” While the general conception and the basic screen design for the
control surfaces were prepared during the design phase, this phase focused on specializa‐
tion and detailed changes. It quickly became apparent that the work took on the charac‐
teristics of rapid prototyping during the pilot phases. Johnson et al. had addressed the
importance of rapid prototyping within the context of using SBD early on [10].
Two examples from the case study here should confirm the importance of a system‐
atic combination and/or integration of rapid prototyping with SBD. At the same time,
they cast a helpful light on a problem related to SBD in a brief discussion following the
examples. The examples concern two particular scenarios that were tested within the
context of the pilot applications: The beverage scenario (conducted by a service robot
provided with a manipulator including a three-finger gripper) and the transportation
scenario (conducted by a less sophisticated service robot, a revised automated guided
vehicle).
The beverage scenario refers to the typical tasks at stations intended to manage the
residents’ beverage supply, which in the case study were to be transferred by a service
robot. Elderly seniors frequently tend to drink too little. Therefore, providing residents
with a sufficient supply of fluids represents a crucial task in nursing facilities, and care‐
givers must make particular efforts to ensure that certain residents have enough to drink.
In the case study, a service robot independently filled a glass at a beverage station, then
offered it to the seniors in common rooms. The robot was to acquire the desired quantity
of fluid, automatically document it, then add up fluids consumed by each inhabitant.
Caregivers can thus quickly establish an overview of the conditions of the residents, and
intervene if necessary. This way, at the end of their shift, caregivers only need to examine
how much each resident has drunk, and then - if necessary - make their own, additional
offers.
Within the context of the beverage scenario, it turned out that several of the residents
in the common room did not notice the service robots because of how quietly they moved
from place to place, so that the seniors were at times startled when a robot offered them
something to drink. This undesired effect could be repaired on site by programming and
activating an additional function which consisted of the robot announcing itself when it
“entered” the room with simple phrases such as “Good Morning,” “Hi, it’s me again,”
etc. Of course, this effect was difficult to recognize in the SBD’s visual aides, and
accordingly was nearly impossible to predict and/or implement before the pilot study.
The second scenario that serves as an example of the problematic aspects of SBD is
concerned with the transportation operations commonly used in nursing facilities. In
nursing facilities such as senior homes, there are many transportation needs. From dirty
laundry to meals to medication, heavy loads must be carried from A to B on a daily
basis, often over long distances. Frequently, these tasks are carried out by experienced
caregivers. The transportation scenario was developed in order to relieve these care‐
givers of this cumbersome routine and thus create more free time for care-giving activ‐
ities. A driverless transport system could accomplish these tasks independently. Both
regular transportation services as well as unique transportation tasks can be delegated
to a driverless transport vehicle. The removal of dirty laundry and delivery of fresh
laundry, for example, is a routine transportation activity that occurs daily, or several
times daily. In addition, however, meal trays, beverage crates, mail, or medications could
also be delivered by such a system from a central office to individual stations or floors,
and/or collected from these stations. These tasks are generally perceived to be time-
consuming and burdensome, as they prevent caregivers from spending more time on
their key responsibilities to the residents.
This second example brings up a core element of the SBD, i.e. the visualization
of the planned operation on the basis of drawn sketches. During the transportation
scenario – which was adjusted several times between user and developer before the
development and first pilot run, just as the beverage scenario was – it turned out that
the containers for the dirty laundry presented a substantial stress to caregivers, since
the opening of the container was too high. Laundry bags may contain wet clothing
and can weigh up to 15 kg, which means that depending on their height, caregivers
may have to lift this heavy load up to their chest in order to deposit it into the
container. As was later discovered, an early sketch showing the revised automated
guided vehicle with a laundry container was used for the scenario adjustment. For
basic adjustment, this was completely sufficient.
With regards to the size of the container, the caregivers presumably regarded it symbol‐
ically, and did not note that the container was too small for practical use, nor indicate how
big it could or – better yet – should be. For their part, the developers tacitly and naturally
assumed that the container, in order to be functional, must be larger. Although in the long
run the development of the transportation scenario was oriented by the rough guidelines
of the scenario, in the end it obviously came to an addition of two opposing “deviations”:
During the design phase, the caregivers did not “look too carefully” at the size of the
container in the drawings (Fig. 1(a)), and the actual container was (obviously) larger in its
execution than it appeared in the sketches (Fig. 1(b)) – too large:
Fig. 1. (a) and (b) The picture on the left shows the sketch of the laundry transportation scenario
used in the scenario adjustment, and on the right the dirty laundry containers which were used in
the pilot run. Both pictures are accurate sketches of the original drawing or photograph, made by
Annika Metze following the authors’ instructions. The sketches were made to ensure the highest
anonymity of the involved persons, firms, and organizations.
As is made clear by the example, the figures used in SBD are not “merely” designs
with a symbolic character, but representations of a prospective reality that should be
taken seriously [11]. If this fact is not considered, any desired positive effect resulting
from an adjustment of planned operations before the development work actually begins
disappears all at once. The “problem” of the laundry container could obviously not be
solved quickly through the use of rapid prototyping (a procedure that derives from soft‐
ware development [10]), and had to be delayed to the next pilot run, as a container with
new dimensions had to be produced.
Apart from the obviously important evaluation of the scenarios, which inhere in the
procedure of SBD and must occur as early as possible within the pilot tests [8: 371f],
these examples also point to another important factor: SBD was developed in the context
of software development, and was initially applied and discussed only within this field.
The examples reveal the limitations of and improvements necessary to the procedure in
different regards: Firstly, it was clear that when using SBD for the development of
complex robots designed for complex social environments, early pilot studies are partic‐
ularly important, and also that SBD would be much more efficient if rapid prototyping
formed an integral component. Moreover, the transfer of the procedure to the develop‐
ment of robots (in contrast to software) makes it much more susceptible to unforeseeable
effects. Reversing the conclusion, this means that in such test scenarios rapid prototyping
becomes all the more important (as far as possible), but also that – precisely because
rapid prototyping is much more difficult to apply given the materiality of equipment
development – considerably greater attention would have to be given to the mode of
representation in the scenarios [11].
3.2 Generating Scenarios - the Design Phases

Two field-specific aspects that were noticeable during the design phase are briefly
discussed below. It was apparent from the survey of the operational procedures that
caregivers remained wedded to the procedures provided by the documentation software
already in use at the facility. This tendency was revealed particularly clearly in situations
in which the information and interaction scenarios with the user interface design were
concerned. In the questionnaire on suggestions for improvement, the (on paper) theo‐
retically more complex and intuitive operation of the robots and/or documentation (e.g.
the quantity of fluids consumed in the beverage scenario) could hardly be determined.
This was because it was nearly impossible for caregivers to deviate from the documen‐
tation routines of the EDP software used in the facility, even though this represented a
substantial improvement from the viewpoint of its usability. The tenacity of a work
routine and the deeply-embedded nature of EDP systems in such routines is evident from
this, and may make improvements impossible. The question thus arises to what extent
relying too much on user interface in an efficiency-increasing innovation may even prove
an obstacle, if the imaginative power of the users is restricted by the “habit of practice.”
A further aspect related specifically to the field of providing care is related to the
seniors’ ability to integrate. Different factors come in to play here, which, depending
upon their field of deployment, can vary greatly. In the case study the field of application
and accordingly the inclusion of user groups were restricted to stationary nursing facili‐
ties. The senior citizens at such facilities are often very close to death, which usually
leads to a general lack of interest in future developments [12, 13].
Moreover, it seems justified to raise the question as to how the scenarios concern
changes that exceed the imaginative power of this particular group of people, and conse‐
quently makes feedback regarding the planned employment of service robotics difficult
if not impossible. Despite repeated interviews with a large number of residents at the
nursing facility, the responses received from this user group were scant. Thus the ques‐
tion arises to what extent SBD is either too concrete or not concrete enough. On the
other hand, these findings may under no circumstance be applied to seniors generally,
since – as was already mentioned – the inhabitants in need of care at a stationary facility
form a special “sub-group” [13].
A presumably more trivial circumstance – yet not insignificant for the iterative
application of SBD – which puts the practicality of this procedure for this particular user
group in doubt, is the fact that the group’s mortality rate is very high, so that even before
the conclusion of the design phase, and shortly before the beginning of the first pilot and
evaluation phase, approximately half of the seniors involved in the coordination process
and the generation of scenario had passed away.
4 Summary
In summary, the fundamental precept of SBD consists in aiding usually interdisciplinary

product development teams and other stakeholders to imagine themselves in the position
of the target group, use context, and product ideas via scenarios and personas. The
increasingly specific nature of the phases during the design process afford a needs-based
technical development, thus providing a good basis for participatory technical devel‐
opment. Moreover, an iterative procedure is supported via increasingly concrete and
detailed scenarios, which provides sufficient freedom for experimentation in problem-
solving and design, while also ensuring continuous workflow management that aids
technological advancement. In consideration of the difficulties that arose during the use
of SBD, the following conclusions for future applications of this method can be drawn:
Ad (3.1) With regards to scenario generation, their clarity should continually
increase, so that the last version of the co-ordinated scenarios has achieved a very high
level of detail; moreover pilot runs should be carried out as early as possible, in order
to single out aspects that do not “graphically present themselves” as soon as possible.
Ad (3.2) In some cases it can be quite sensible to ignore user feedback, above all if
the planned development represents an “obviously” better solution than the system
currently in use; regarding the integration of certain user groups two things should be
considered: Does the technology being developed lie beyond the intellectual horizon of
this particular user group? Is the affected user group sufficiently motivated to aid in
developing the technology?
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Iso-Verl, Saarbrücken (2011)
Constructing Third Age eHealth Consumers
by Using Personas from a Cultural Age
Perspective
Maria Ekström1 and Eugène Loos2(&)

1
Laurea University of Applied Sciences, Metsänpojankuja 3, FIN-02130 Espoo,
Finland
[email protected]
2
University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam,
The Netherlands
[email protected]
Abstract. Society ages and our already extensive use of a host of different
portable devices continues to expand. No leap of the imagination is needed to
grasp that an exponential growth of the eHealth market is at hand. While the
ageing of the baby boomers will have an impact on the global economy as a
whole, of particular interest is the impact this will have within the context of
eHealth market development. We wish to clarify and raise the level of awareness
about how older age identity is constructed in the marketer-consumer dialectic
within the eHealth context and how the personas method can be used from a
cultural age perspective. Our focus is on the process of third agers becoming
eHealth consumers. We present an analytical framework for future studies
aiming to analyze eHealth offerings. This will allow us to gain insight into the
process of constructing the third age eHealth consumer group’s identity through
multimodal communicative acts, as is the case in advertising, or in settings
requiring interactivity, such as the service design process. It is through these
multimodal acts that new eHealth offerings could be marketed to the third age
eHealth consumer, focusing especially on both the written and visual lan-
guage used. Our approach is meant to offer an alternative to studies in which
ageing has mostly drawn upon the chronological age concept and where mar-
keting has not been seen as a discursive practice shaping consumers’ identities.
Keywords: eHealth Services Third age eHealth consumers Personas

Cultural age
1 Introduction
Western societies today have more older people than ever before. The question is: how
can these societies cope with the challenges of this growing number of people who are
very likely also to require care and support? One answer is to create solutions for
“aging in place” (Rodeschini [1, p. 521]), which refers to the ability of older people to
remain living in their homes for as long as possible, through the use of various tech-
nologies. Rodeschini [1] makes a distinction between AT and ICT, drawing on research

DOI: 10.1007/978-3-319-20892-3_4
36 M. Ekström and E. Loos
by e.g. Blaschke et al. [2]. Whereas AT (Assistive Technologies) is mainly about health
monitoring, ICT (Information and Communication Technologies) is more about
communicating and informing [2, p. 523], e.g. the Whatsapp users who designed a quiz
that demanded that users change their profile picture whenever they gave a wrong
answer is a case in point - the technology was already there, but the users themselves
designed the use. For this paper, we concentrate more on ICT than on AT; the focus of
our analytical framework is on the encounter between third age consumers (see Sect. 5
for a clarification of this concept) and the eHealth providers and designers.
In our approach, we build on the personas method that was introduced by Cooper
[3] in 1999 within the context of software design. The personas approach is usually
aimed at finding a typical average user: “Creating personas involves identifying the
critical behavior patterns and turning them into a set of useful characterizations”
(Goodwin [4, p. 242]). According to Goodwin, personas can, but are not required, to be
created with the help of demographics, unlike the use of segmentation techniques,
which in most cases are based on demographic criteria. In our opinion, the personas
method certainly has advantages, although the use of chronological age as an age
variable is problematic, as this might invoke stereotyping effects (see e.g. Turner and
Turner [5] who argue that stereotyping is highly prevalent). To avoid this risk of
stereotyping, we use the concept of cultural age, which refers to the way a person
experiences her or his age (in contrast to cognitive age, a concept introduced by Barak
and Schiffman [6] in 1981 referring to a person’s self-perceived age (feel-age, look-age,
do-age, and interest-age).
Hence the cultural age concept addresses the issue of stereotyping and puts forward
the dialectic that is always present when something is designed for or with a user
group. The aim is also to find more viable, sustainable solutions in accordance with this
(see also [7]). This is important because there will probably be an exponential growth of
the eHealth market, where eHealth providers and designers, as well as older users, will
meet to create new better solutions through the use of different, existing tools. Note that,
although we refer here to a ‘market’, we are well aware that the size of any market is not
easily measurable, but must necessarily be estimated by using various statistical data.
Paul Sonnier, a famous social entrepreneur (http://storyofdigitalhealth.com/about/),
addresses this issue by pointing out that the digital health market is not monolithic and
has to be parsed with information from different sources (personal communication,
September, 20, 2014).
The growth of this market is coupled with the ageing of our society, as well as the
extensive use of different portable devices.1 From an ICT-perspective, it is important to
note that there is an average growth of 9.9 % in health-related use of the internet in, for
example, Denmark, Germany, Greece, Latvia, Norway, Poland and Portugal (according
to the results of an extensive survey conducted in 2005 and 2007 [8]). At the same
time, something called mhealth has also emerged, which puts a different light on the
consumer’s role. Akter and Ray [9] emphasize how a consumer perspective on mhealth
services could be an important factor in creating possible business growth through
1
We will use eHealth throughout our paper to describe the new services that are relying on ICT even if
we include portable devices.
Constructing Third Age eHealth Consumers 37
scalability. Focusing on consumer needs is important in the process of empowerment

and when creating sustainable solutions [9, p. 79]. Affordability, availability, awareness
and acceptance are major concepts when creating mhealth services [9].
2 Awareness About Constructing Older Age Identity

in the Marketer-Consumer Dialectic in an EHealth Setting
Whitten, Steinfield and Hellmich [10] have presented the “21st century health care
consumers” as an important driving force in the development of eHealth. In this paper,
we will scrutinize the role of the consumer [11, 12], and especially that of the ageing
consumer, within this context. We use the definition of eHealth suggested by Eng [13]:
“e-health is the use of emerging information and communications technology, espe-
cially the Internet, to improve or enable health and healthcare”, but have expanded this
to include a consumer perspective. We also wish to emphasize that we treat markets as
scripts, i.e., eHealth markets do not exist as such, but are born in different encounters
between providers and consumers (in other words, the market is socially constructed;
see further Storbacka and Nenonen [14]. According to consumer culture theory (see e.g.
Arnould and Thompson [15]), the various different kinds of consumers do not exist
without the encounter, or as Caruana and Crane [16, p. 1498] phrased it: “Consumer
culture theory assumes consumers do not (pre-) exist ‘out there’ as homogenous, a priori
categories.” Markets are in this sense a social construction, emerging through discursive
practices. In these encounters the role of the older consumer and how she or he will be
identified is important. One basic problem is that marketing practitioners often use the
chronological age concept to identify consumers. The chronological age concept [17–
19] easily gives a too static view of a consumer and her or his actions. Marketers often
do not take into account the diversity in the older age group [20]. According to Rodeschi
[1, p. 524], in the development of new technology with or for older people, the
dynamics in the relationship between older people and technology should be more
critically examined. Rodeschini also points out that it is important to focus on ageing.
With the following quote, we attempt to clarify our approach: “Consumer culture
theorists have turned attention to the relationship between consumers’ identity projects
and the structuring influence of the marketplace, arguing that the market produces
certain kinds of consumer positions that consumers can choose to inhabit. While
individuals can and do pursue personally edifying goals through these consumer
positions, they are enacting and personalizing cultural scripts that align their identities
with the structural imperatives of a consumer-driven global economy” [21, p. 871].
In the following, we will discuss the chronological age concept that we see as
problematic when designing eHealth services for and with older people, as well as in
the use of personas.
3 Contesting the Chronological Age Concept
As mentioned above, we feel that the chronological age concept is a problematic one.
Additionally, in our view, markets are born in specific encounters between, for
example, consumers, eHealth providers and designers. To understand how the third age
eHealth consumer (see Sect. 5) will be constructed in such encounters, we need another
way of understanding these older people, in order to avoid being overly influenced by
the chronological age concept as discussed in the previous section. So, on the one hand,
a more dynamic view of ageing is important. But on the other hand, chronological age
is an important concept for most of us. We define, categorize and position ourselves in
relation to others on the basis of the magical numbers telling us how long we have been
walking on earth. Chronological age is in fact as important a dimension of categorizing
people as race and gender [22]. Knowledge of the chronological age provides infor-
mation about the possibilities of accomplishing certain goals. The possibilities for
becoming a world famous opera singer at the age of 50 are different from those at the
age of 25. But what makes this age concept problematic is that it is often presented as a
fact, or as an independent social category [23]. If consumers are defined on the basis of
their chronological age alone, this gives rise to the notion that a person and her or his
abilities are definable by her or his age. However, in everyday life, age is created and
recreated when interacting and communicating with other people. In this we follow
Nikander, who states: “(…) the focus in the current work is exclusively on the com-
municative and dialogic processes in and through which situational meanings of age
and ageing emerge in interaction” [23, p. 13].
We also follow Mathur and Moschis [24], who emphasize processes where adults
learn roles and norms connected to older age. To create more dynamic eHealth solu-
tions, we suggest that these roles and norms be made visible. We also submit that the
consumer’s identity is created through discursive practices, which are materialized in
advertising, for example. We do not want to see the older consumer as passive and the
marketing practitioner as active, as presented by Bristor and Fischer [25]. We feel that
marketing is a practice that shapes roles, identities and norms, a view that is similar to
the thoughts of Hackley [26–28], Penaloza and Gilly [29], Hänninen [30] and Puus-
tinen [31]. We want to ameliorate the communicative literacy [32] among older con-
sumers as well as among eHealth providers and designers creating different eHealth
services.
We define reality as socially constructed, and hence research in this field and our
contribution to the discussion about older consumers in this field should be seen as a
social construction. The much-used monolithic approach, in which consumers are
described using the chronological age concept, has not been conducive to a dynamic
discussion. Our aim is to create a more vivid discussion leading to a more dynamic way
of seeing older people.
4 A Cultural Perspective on Age and Identity
Our contemporary society is increasingly defined by consumption. It has even been

stated that we define ourselves through consumption of different products and services.
Arnould and Thompson [15, p. 868] have analyzed so-called consumer identity pro-
jects and related these to consumption through which consumers both create and search
for an identity. When identity is seen from this perspective, brands are mostly involved:
people use certain brands to strengthen a desired identity. We wish to emphasize how
the discursive practices of practitioners create frameworks of interpretation in which
older people find their identity. Hence we are not talking about identity projects that use
brands to underline a consumer’s identity, but rather about how discursive practices
shape the way consumers find their identity.
While Katz [21] talks about cultural ageing, we would like to introduce the concept
of cultural age, as analogous to the concept of chronological age. The difference here is
that we emphasize how age is constructed through representation and interaction. The
concept is to gender what chronological age is to sex (see the discussion about the
concepts in Rubin [33]). Gender is defined as the way the masculine or the feminine
role is constructed in different discursive practices; sex has to do with the visual
biological differences between a man and a woman. By analogy, we all have a chro-
nological age, but also a cultural age by which our identities are shaped as old or young
in interaction with each other.
5 The Combination of Older Age and Consumption
To illustrate our perspective on the role of older people in the design process of eHealth
services, we provide an example taken from a consumption context. Until recently,
older people were not regarded as an interesting consumer segment. One of the reasons
for this was that they were seen as consumers with traditional consumption patterns
(see e.g. Suokannas [19]). This situation has changed, mainly because marketers have
begun to be convinced that this segment is valuable. The baby boomers who changed
society in the past [34] are now having a similar effect in the marketing context. This
has led to a wholly different idea of who the future older consumers will be: “The little
old lady of 2025 won’t have a spotless Ford Fairlane (that she drives once a week, to
church) sitting in her garage, She’ll be buzzing around town in an Alfa-Romeo
(standard equipment with hydraulic lifts), dressed head to toe in the Nike “Silver” line,
parking in the plentiful spaces reserved for people who are old but not impaired (as
mandated by the 2009 Perky Aging Americans Act). Thanks to improved health care,
nutrition, fitness and cosmetic surgery, at seventy she'll look and feel like her mother
did at fifty” ([35], pp. 129–130).
This quote emphasizes the differences between the way older people of the future
are expected to look and act, and the older people we have been used to. However,
while this may hold true for third age [36], i.e., those who are healthy (and often rich
enough) to be marketed as a valuable consumer segment to marketers, obviously this
will not apply to the category of older people who are not as fortunate (see Loos [17]
for two discourse coalitions related to these two kind of older people: the eternally
youthful seniors and the frail needy seniors, and see Suokannas [19] and Loos and
Ekström [20] on other possible categorizations of older people).
In this paper we focus on older people who are in their third age and on how their
identity as active eHealth consumers is constructed (by themselves and others, such as
eHealth providers and designers). In other words, we want to understand the process of
becoming a third age eHealth consumer. We therefore present an analytical framework
for future studies aiming to analyze eHealth offerings and to gain insight into the
construction of the third age eHealth consumer group’s identity through multimodal
communicative acts as is the case in advertising or in settings requiring interactivity,
such as the service design process. These multimodal acts could be the way new
eHealth offerings are marketed to the third age eHealth consumer, focusing especially
on both the textual and visual language in use. Our approach is meant to offer an
alternative to studies in which ageing has mostly drawn upon the chronological age
concept and where marketing has not been seen as a discursive practice shaping
consumers’ identities (see also Loos and Ekström [20]). As these markets develop, it is
important to raise the awareness of age stereotypes, confront possible ageism in society
and to develop communicative acts of high ethical standards. By using and elaborating
on the Foucauldian “technologies of the self” (Foucault [37] - in other words, by
making visible the ways older people are constrained or empowered in our society - we
aim to find a means to reach our goal.
6 Towards the Use of Personas for the Design of EHealth

Services for Third Age Consumers
Within the emerging field of eHealth services, it is important to find out how the
dynamic dialectic between the ageing discourse and the eHealth discourse, as discussed
in this paper, will construct the third age eHealth consumer. To that end, we proposed
to use a specific method called personas creation [3, 38]. In the past, personas have
largely been used to derive a more hands-on impression of users within product or
service design. We propose to use personas for eliciting the various power relations and
the dynamics of specific encounters in which the third age eHealth consumer is con-
structed. To our knowledge, this method has mainly been used to create fictive
personas. The use of personas as a method may enable a better understanding among
eHealth providers and designers of the third age eHealth consumer, although care
should be taken to avoid the risk of creating stereotypes. This might occur if designers
allow themselves to be led by the chronological age concept. We recommend scholars,
marketers, eHealth providers and designers in this field to further develop this method
by adopting our cultural age concept in order to avoid too much stereotyped catego-
rization. As personas are archetypes and the aim is to develop these distinct types,
Fig. 1. Constructing the third age eHealth consumer

stereotyped categorization can easily occur (see Sect. 1 and [3, 38]). Although personas
are used to create a deeper connection with the user by narratives, the hypothetical
persona is described through the use of chronological age. In other words, eHealth
providers and designers are creating offerings that are informed by this age concept. By
focusing on how age is constructed and making use of the cultural age concept,
personas can be created in a more realistic way.
In Fig. 1, we finally visualize how the third age eHealth consumer will be
constructed in the dynamic dialectic between the ageing discourse and the eHealth
discourse, in relation to the creation of personas. As explained in this paper, this
process will take place in specific encounters between third age eHealth consumers,
providers and designers.
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Capturing Older People’s Cognitive Capability
Data for Design
Shan Huang1 and Hua Dong2(&)

1
College of Architecture and Urban Planning, Tongji University,
Shanghai, China
[email protected]
2
College of Design and Innovation, Tongji University, Shanghai, China
[email protected]
Abstract. There is a lack of cognitive capability data in design. Existing capa-

bility databases lack consideration of older people who are suffering decline of
cognitive capabilities. To explore older people’s cognitive capability data for the
design context, two pilot studies were conducted: a small-scale cognitive capability
survey in China, and a study of a group of industrial designers’ needs regarding
user data. A Framework of user data were developed and key issues for cognitive
capability data collection and application in design were identified and discussed.
Keywords: Cognitive capability User data Design for older people Human
factors and ergonomics
1 Introduction
In the context of design, capability refers to an individual’s level of functioning, from

very high ability to extreme impairments, which has implications for the extent to which
they can interact with products [1]. However, the study on user cognitive capability data
is relatively weak comparing to other functional capability data. For instance, the ongoing
“Basic Chinese adults’ ergonomics data collection” project by the China National
Institute of Standardization (CNIS), has added the measurements on sensory capabilities,
such as visual and hearing abilities [2]. But this project has not yet covered the mea-
surement on cognitive capability. This is probably because it is more difficult in mea-
suring cognitive capability [1]. A study named Towards Better Design [3] initiated by the
University of Cambridge has incorporated cognitive capability measurement, but the tests
were mainly adapted from cognitive psychology, thus having limited relevance to design.
Technology development pushes older people into the mobile-internet world, and
there is a need to understand how they interact with information and communication
technology. Cognitive capabilities play an important part in older people’s interaction
with these technologies.
1.1 User Capability Data

User capability data, derived from Human factors and ergonomics (HF&E), are widely
recognized as a good resource that informs design in the early stages [4]; they are
fundamental to the design of safe and usable products [5].
DOI: 10.1007/978-3-319-20892-3_5
Capturing Older People’s Cognitive Capability Data for Design 45
Categories. There are two categories of user capability data: (1) physical capability
data, (2) functional capability data [6] (Fig. 1). Physical capability data refer to tradi-
tional human factor data such as height, grip strength and the reach of limbs, which are
associated with physical attributes. Functional capability data relate to senses, cognition
and motion; and there are more and more studies focusing on these fields [7, 8].
Fig. 1. Categories of user capability data (adapted from [6])
Functions. The benefits of involving user capability data in the design process are two
folds. On one hand, it can serve as benchmarks that assist designers to make the
design decisions and to estimate whether the design is accessible or not. And the
metric that can serve as the benchmark is the significant element of design evaluation.
By providing suitable metrics, designers should be able to measure the success of
their designs and also identify accessibility shortcomings [6]. Apart from that, the
range of capabilities is also an essential factor. Johnson et al. claims that tools for
predicting difficulties need to be able to “give designers a picture of the full range of
capabilities and also the ability to consider and understand the multi-dimensional
nature of capability profiles” [1]. On the other hand, designers regard user capability
data as resources that can inspire them. Design is a series of mental processes,
manipulating intelligence to discover and solve problems, with moments of sudden
illumination [9].
Capture Methods. Self-report and performance measure are methods commonly used
to assess physical functions in health surveys of older people [10]. The method of
self-report is based on a series of questions, which offers a fast, low-cost and easily
executed path to users’ information that can be gathered by questionnaires,
face-to-face interviews or remote interviews (telephone or online interviews). Proxy
response is a kind of self-report that can be conducted when an interviewee cannot
answer by himself/herself. However, that should not be equivalent to self-report,
because research has shown that a proxy report is not as accurate as self-report for the
rating of ability to perform activities of daily living (ADLs) among older people [11].
Based on Fors and his colleagues’ study [10], the limitation of self-report can be listed
as follow:
46 S. Huang and H. Dong
• There is limited value in identifying clinically significant change.

• Lack of reliability: the subjective factor as individual expectations and aspirations
may affect a person, especially an older one, to comparing to peers and level of
functioning in earlier life.
• Be sensitive to the influence of cognitive impairments, culture, language and
education.
Compared to self-report, performance measure appears to be safer, quicker and easier
to administer when large samples are employed [11, 12]. Apart from that, performance
measures are standardized tests designed either to mimic ADLs (e.g., reading message
on cards to simulate using the message function of a mobile-phone) or to measure more
specific dimensions of cognitive function (e.g., short-term memory, visual
discrimination).
Both self-report and performance measure can be used in surveying cognitive
capabilities [1]. Self-report involves questions about respondents’ past experience,
which can help access not only their physiological capability, but also attitudinal,
environmental and cultural components. Performance measure can help collect some
capability data more precisely.
1.2 Older People’s Cognitive Capability

Cognition abilities are typically used in combination to perceive information, and the
function of cognition can explain information processing [13]. But complex informa-
tion processing contains much more than a cognition process. Figure 2 shows a model
for the typical cycle of perceiving, thinking and acting that occurs in the interaction
with a product [7], which suggests that the ability to successfully interact with com-
puter terminals could be predicted according to the demands made on users’ sensory,
cognitive and motor abilities [14]. Information perceiving, memory and acting process
compose a rounded cognitive process, and the cognitive capabilities involved in that
process are considered in this study.
Individuals of all ages believe that memory undergoes a relatively precipitous decline
after age 40 [15]. This cognitive retrogression makes it more challenging to design for
older people. Older people’s cognitive capabilities are mainly reflected in their visual
perception, auditory perception, memory abilities and their sometimes attitudes. These
factors are not isolated, but inter-related. Due to the decline of perception, older people’s
perception of time is intentionally longer than the other adults [16]. And due to their
habitual thinking, acting and the decline of memory, their learning capacity falls sharply
after age 45 [17], which often makes it more difficult for older people to learn to use
products that they are not so familiar with (e.g. some mobile-internet products).
2 Pilot Studies
Many studies show that existing user capability databases are still lack of the con-
sideration of older people [18]. Inclusive design as a design methodology emphasises
on consciousness of the demands to design for a wider range of users, including the
Fig. 2. A typical information-processing model for a product interaction (adapted from [14])
demands of older and disabled people. Studies also suggest that existing ergonomics
database are lack of the consideration of designers [19].
An ideal user capability database need to be able to give designers a picture of the
full range of capabilities and also the ability to consider and understand the
multi-dimensional nature of capability profiles [1]. Therefore, two pilot studies were
conducted to get insights into older people’s cognitive capability data for design.
2.1 Pilot Study 1: A Small-Scale Cognitive Capability Survey in China

The first pilot study was a small-scale cognitive capability data collection, which was
conducted by the Inclusive Design Research Group at Tongji University. It covered seven
different cities and towns of China. The age range of respondents was from 50 to 80. Both
self-report and performance measures were employed in the study. Self-assessed mea-
sures most likely draw on the participants’ experiences from their everyday life whereas
performance-based measures are more specific and standardized [10].
This pilot study was the cognition section of a multiple capability-related data
survey conducted by the Tongji University. The survey questions were derived and
adapted from Towards Better Design [3]. A variety of data were collected in this
survey, including vision, hearing, dexterity, cognition, health condition, and contextual
data collection. Table 1 summarises the methods employed in measuring different types
of capabilities (i.e. component functions). As seen in Table 1, Cognitive function was
measured through self-report.
A toolkit was designed for collecting multiple capability-related data. Figure 3
shows the tools included in the toolkit.
This paper focuses on the aspect of cognitive capability. The questions were
directly derived and adapted from the field of psychology. For instance, to test
short-term memory, the respondent was asked to recall the words that were prerecorded
Table 1. Summary of different measures used in the study
Fig. 3. The toolkit for the pilot multiple capability survey in China
in an audio file; to test their comprehension, a made-up medicine prescription was

given to the respondent, followed by a few questions to test whether the respondent has
fully understood the prescription; to test numerical abilities, the respondent was asked
questions relating to his/her use of numbers in everyday life.
Main Findings. The cognitive data collected from the study seem to have little direct
relevance to design, and it is difficult to predict product interaction based on the data
collected. In addition, many respondents tended to overestimate their abilities in
self-reporting.
Discussion. As the cognitive questions are mainly derived from the fields of psy-
chology and healthcare surveys [20], the results have limited use for design. In the
design process, user capability data are applied to predict a solution of a specific design
problem, aiming at making the product more accessible to target users. Therefore it is
important to develop new, design-relevant cognitive measures. In addition, because
self-report is subjective [8], it is necessary to introduce objective measures in cognitive
capability test.
2.2 Pilot Study 2: A Study of Industrial Designers’ Needs for User Data
In order to develop design-related user capability survey, it is important to understand
designers’ needs regarding user data, including users’ cognitive capability data.
Existing ergonomics data are not designer-friendly; a study carried out in the UK [7]
shows that ‘all the interviewed designer considered the existing anthropometric data
out of date, and seven out of ten believed the data was irrelevant or not applicable to
their specific field of design practice.’ So what are the useful and usable user data for
design? A study was conducted with industrial designers to identify their needs.
There were two steps in this study. In the first step, 12 in-house designers, 12
consultant designers and 12 freelance designers were invited to answer a questionnaire.
The questions covered the time designers use in understanding user capabilities, the
means designers usually adopt when they need user data, the data designers prefer, and
how they use user data in the design process. Table 2 shows the profiles of the
participants. In the second step, designers from each category in the step 1 were invited
for a focus group discussion, and three designers were able to participate in the focus
group.
Table 2. The profiles of the designers participating in the study

Categories of designer Design field Number Total
In-house designer Digital device 4 12
Household appliance 4
Engineering product 4
Consultant designer Digital device 4 12
Household appliance 4
Engineering product 4
Freelance designer Student major in design 6 12
Other 6
36
Main Findings. The results showed that different categories of designers spent quite
different time in understanding user capabilities. In-house designers (27 %) spent more
time than the other two categories of designers, while freelance designers (7 %) spent
least time. Apart from that, the proportions of time designers spend on user data
differed for different types of designs. There is a consistent trend that designers spent
more time on understanding users for digital device design than for household appli-
ances, and for engineering product design, designers seem to spent less time in
understanding user capabilities.
The designers most often searched the Internet for information about their target
users. The designers in the field of engineering product design preferred ergonomics
data. Small-scale user research was a crucial method for designers to get first hand data
of users. Almost all of the designers who did not prefer ergonomics data claimed that
current ergonomics database was hard to use and had little relevance to their specific
design problems.
There was not much difference on the preference of data formats among the three
types of designers. The respondents all preferred visualized data (e.g. photos and
informational graphics) than text information (e.g. numerical data). Designers needed
both qualitative data and quantitative data. Moreover, some designers considered
descriptive words as a kind of qualitative data that could help them to quickly get the
information of target users.
It was also found that designers needed user data throughout the whole design
process. Designers usually used qualitative data to get conceptual inspiration, and
quantitative data could help designers to explore references to support a specific design
decision.
Discussion. The study of designers’ needs for user data suggest that a new type of user
data (probably differ significantly from existing ergonomics data) is needed by
designers, which should contain both qualitative and quantitative data. These data
should be developed to support design activities at different design stages.
3 A Conceptual User Data Framework
Based on literature review and pilot studies, a conceptual user data framework was
developed to illustrate the landscape of user data for design (Fig. 4). On one hand,
quantitative data are obtained from larges (population), which can be regarded as
benchmarks in the design process. On the other hand, qualitative data are obtained from
relatively small samples (i.e. individual users), which can help designers to get con-
ceptual inspiration. Most of existing capability databases focus on data collection. In
contrast, designers tend to focus on data application. Therefore, establishing the con-
nection between data collection and data application is the key issue for a
designer-oriented user capability database.
Fig. 4. The range of user capability data
In addition, it is also crucial to ingeniously combine quantitative data and quali-

tative data. Ergonomics data are often quantitative data, which cannot provide
designers with contextual information of users. Particularly, in the concept generation
phase, qualitative data are more helpful for gaining insights into target users.
4 Conclusions and Further Study
In a word, it is necessary to develop survey questions that can help collect older
people’s cognitive capability data for the purpose of improving design. Tests in the
field of cognitive psychology can be used as a source of reference. Crucially, the test
tasks (including self-report questions and performance measured tasks) should be
related to product interaction.
The further study should aim to solve two critical questions:
(1) How to make cognitive capability data useful to designer?
(2) How to make the data easy to use?
In addition, more designers from different fields should be involved in the future
study; this will help gain a deeper understanding of designers’ needs and desires, so as
to make the database useful and usable for the design community.
Acknowledgments. We thank all the people who participated in this study. Many members of
the Inclusive Design Research Centre (China) helped data collection in the pilot study; our
sincere thanks go to Ning weining, Zhou qian, Cui xiaochen, Jiang yingcheng, Zhang yingyu, Ma
xuezi and Zhang wenyun.
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Accessed 12 Oct 14
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human-product interaction. Appl. Ergon. 43(4), 713–726 (2012)
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Designing Tangible Interactions for Aged Users Though
Interactive Technology Prototyping
Wei Liu1 ✉ and Yanrui Qu2

( )
1
Tongji University, Shanghai, China
[email protected]
2
Beijing University of Technology, Beijing, China
Abstract. This research aims to explore how to bring the richness of tangible
interaction designs into the everyday living and working contexts of the aged
users. To do so, we introduced an interactive technology design at two Chinese
Universities, for the first time interactive prototyping skills become important for
their undergraduate and graduate students to learn and practice. In an interactive
prototyping course, a number of prototypes designed for aged users were built
and experienced. From these prototypes, experiences for regularly running inter‐
action design education based on traditional industrial design education were
discussed.
Keywords: Interaction design · Interaction qualities · User experience ·

Interactive design technology · Context of use · Aged users
1 Introduction
Being educated as industrial designers, the design students at the Tongji University and
the Beijing University of Technology are used to and are good at crafting physical car
models, designing graphical illustrations and making Chinese porcelains. However,
interaction design, specifically interactive prototyping will play a crucial role in their
educational curriculums in the coming years. In order to improve the fit, we organized
an interactive technology design course with experts from practice. The goal was to help
the students learn and practice interactive prototyping skills by developing interactive
and working prototypes.
Key questions for students are: how does aged users experience and use a product?
What is his understanding of that product? Is it the design of the product that determines
or influences these responses, the needs and abilities of the user, or the environment in
which it is used and its social context? Experience design [5, 9, 23] brings a broad
perspective to the design of product interaction, encompassing such traditional activities
as product styling and user-centered design but additionally requiring attention for all
psychological effects elicited by interaction including stimulation of the senses, meaning
and value attribution to the product and the feelings and emotions that are elicited. In
the traditional product design process [12, 19, 30], there are insufficient provisions to
consider the design of interactive products. Alternative approaches propose a highly

DOI: 10.1007/978-3-319-20892-3_6
54 W. Liu and Y. Qu
iterative design process that allow for concepts to grow by making experiential proto‐
types (also called sketches in the early stages of the design). Important roles of these
prototypes are to allow the designer to communicate the concept to the design team and
to give him insight on how well the designed features of the interactive product concept
match the design brief.
2 Related Work
In aged user interaction design domain, Keller [10] designed cabinet that helps designers
collect and organize their visual material for inspiration. The design makes interaction
with digital material more physical by dragging digital images on a table as if they are
real objects. It offers a fluent way to add physical material to the digital collection by
digitizing and projecting any objects placed on the table. This type of study was followed
by several other recent projects in the domain of computer supported collaborative work
(CSCW), such as designing an intelligent robot worker that transports goods and samples
in semi-public hospital context [13] and designing a shape-changing communication
device that facilitates expressive ‘knocking’ communications [20]. Another example is
the intelligent reading lamp, which aims to demonstrate ethics and esthetics in products
and systems. By moving the hand over the lamp, a ‘living light’ can be directed onto an
object such as a book.
3 Settings
The interactive technology design course aims to equip students with design theory while
gaining practical experience in the development of interactive prototypes, which utilize
potentials of embedded interactive technology in products in terms of enriching user
experience [1, 6, 7, 22]. Max/MSP, Phidgets sensors and Arduino were selected as
development environments. These tools make it possible to build experiential proto‐
types, even with students who have few electrical and programming skills [15–17]. Fifty
students worked in teams of three on three design briefs concerning aged user group’s
styles of interaction in an office context. The concept and prototype development
involved a total of five phases. The first two phases focused on exploring conceptual
possibilities and building initial prototypes by hacking existing products. The third phase
aimed to nut-crack the hardest technological problems and further develop the concept
to a mature level. The fourth phase involved users, while the last phase targeted on
integrating user comments to finalize the prototypes.
4 Approach
Our research objective has been to explore how to bring the richness of tangible inter‐
action designs into the everyday living and working contexts of the aged users. This is
an interesting challenge that presents itself to developers, designers and researchers. The
course lasted for a total of seven calendar weeks. It run in parallel with others and it was
Designing Tangible Interactions for Aged Users 55
supposed to take up one and half days per week. We developed a design brief together
with the brief holder who contributed some money to partially cover prototyping mate‐
rial and expenses. After a kick-off presentation, the students were distributed into teams,
and each team received the same brief. We made sure that each team had at least one
technology-focused students, although the course does not assume any technology
expertise. The course consists of five iterations of increasing length, each one producing
a prototype with a different focus. The five iterations can be summarized under the form
of assignments given to the students.
We envisage using interaction qualities [3, 14, 21] as design guidance and a new
approach that can help researchers, designers and students to integrate functional design,
experiential interactions and interactive technology. Some interaction qualities (e.g.,
playful, collaborative and expressive) were explored and used as design guidance. The
students were asked to explore IT supported user-product interactions through learning
the characteristics of different sensors and actuators, how to program them, and how to
employ them in realizing engaging interactions [26, 28, 29]. They had to focus on the
experiential interaction qualities instead of programming details. The primary goal for
the students was that it had to be a working demo and to be engaging for aged users.
5 Interactive Technology Designs
From the beginning and throughout the whole research, digital and physical prototypes
that are rich in aesthetic, expressive and experiential quality are built and tested in real
living and working contexts. To ensure a high flow of thoughts, ideas and knowledge,
a research through design approach is taken, in which the generation of knowledge and
the development of applications go hand in hand. Research through design is used as a
form of research to contribute to a design activity [2, 4]. It is recognized as a form of
action research, defined as systematic investigation through practical action calcu‐
lated to devise or test new information, ideas, forms or procedures and to produce
communicable knowledge [8, 31]. Action research is an iterative process involving
researchers and practitioners acting together in a particular cycle of activities [24, 25].
The research through design approach is highly iterative, integrating theory and practice
from different fields into working experiential prototypes. These prototypes can be
experienced as working artefacts and can be used as research means to demonstrate and
explore these theories [11, 18]. Designing and building working prototypes that are rich
in experiential quality therefore plays a key role in this approach. The reflection on the
action (of designing and building) creates new knowledge. The designing act of creating
prototypes is in itself a potential generator of knowledge [6, 17], leading to new design
insights and refinement of research issues. Below are brief descriptions of three concept
interactive designs for aged users, concerning their real living and working contexts.
5.1 Glasses
Glasses is an interactive installation designed for aged users with bad eyesight. They
wear glasses to read newspapers and might always forget where the glasses are put. This
design helps them to allocate the glasses and to form a good habit of putting the glasses
56 W. Liu and Y. Qu
in a box. A user swipes in the front of the box to open it. After reading, while the user
folds the glasses, the box opens and lights from inside glows. This indicates the user to
put back glasses in a good order. Infrared and bend sensors are embedded in the box and
in the glasses. See Figs. 1 and 2 for an impression. A video scenario can be found at
http://v.youku.com/v_show/id_XNTkxMDA5OTgw.html.
Fig. 1. The user interaction of glasses
Fig. 2. The design and development process of glasses
5.2 Toy
Toy is a pair of interactive devices designed for aged users and their family members to
communicate with tangible inputs. A user touches and twists one device to trigger rota‐
tion and light effects on the other device. This indicates that a message is sent and
attention is needed. Rotation and light sensors are embedded in the design. See Figs. 3
and 4 for an impression. A video scenario can be found at http://v.youku.com/v_show/
id_XNTkxODEyMzI0.html.
Fig. 3. The user interaction of toy
Fig. 4. The design and development process of toy

5.3 Puppet
Puppet is an interactive device designed for aged bus drivers. This design helps them to
exercise and get a quick massage after a long time driving. Every one hour, the device
activates and asks the user to rest for a while. It starts vibrating and generates voice
commands, which guides the user to tap and massage shoulder, arm, leg, etc. After
completing the commands, the vibration stops. Vibration, touch and gravity sensors are
embedded in the device. See Figs. 5 and 6 for an impression. A video scenario can be
found at http://v.youku.com/v_show/id_XNTkzMjY3MTE2.html.
Fig. 5. The user interaction of puppet
Fig. 6. The design and development process of puppet
6 Discussion
All prototypes show promise by providing novel user interactions - that is the power of
making experiential prototypes. From working on the design assignment, the students
understand that aged users, context and action are the key elements of interaction design.
They designed and tried out various ways of interacting. With skills, students can design
and build more interactive prototypes in other domains.
We have mentioned that the objective of the course is to teach students how to create
concepts in a group for interactive products manifested as interactive experiential proto‐
types. This objective places technology in a clear ancillary role. The course structure,
based on group work, tends to obscure individual contributions and, in particular, makes
it impossible to evaluate the degree to which students have learned prototyping tech‐
nologies. Moreover, the number and complexity of the deliverables encourages the
students to take on the project roles that we have already mentioned. In learning terms,
the consequence is that a student may go through interactive technology design without
ever writing a line of code or touching a soldering iron. While the course has a big space
for techniques of all sorts, something that we personally delight in, it remains a design
course in a faculty of Design.
58 W. Liu and Y. Qu
The course was done in an educational setting but not in a practice setting of
commercial product development, because in the educational setting we can take
control, pay attention to design interactions and structure the course as an exercise, which
does not have to have full complexity and pressures of commercial reality. The students
in the course are also treated as designers.
The limitations of this course include the short amount of time, insufficient knowl‐
edge on interaction design from the students and lack of comprehensive user tests.
7 Conclusion
We have presented the model of interactive technology education. We have seen this
aggressively prototyping oriented approach produce good designs that have resulted in
publications and products. Our contribution to the existing body of knowledge is to draw
attention to IT supported new ways of interacting that will have a great influence on
aged users. Our findings have implications on the development of the future products,
services and systems for aged users should utilize the power and advantages of modern,
appropriate and innovative interactions and technologies. We believe that this same
approach could be used for other adjacent domains that do not have a physical base like
web application design or mobile application development. Designing and prototyping
interactions successfully promoted the students to learn and practice interactive proto‐
typing skills.
8 Future Work
In order to accumulate experience on interaction design education, the next step is to

conduct more prototyping studies on the incoming research projects within the college,
to run user tests and to set a curriculum syllabus. These prototypes will get evaluated
based on how it functionally works, how its user interactions fit into context and how it
can benefit future ways of living and working for the aged users.
Acknowledgements. We thank all students for their enthusiasm and hard work. We thank Aadjan
van der Helm and Marco Rozendaal for their knowledge. We thank Microsoft Research Asia for
their support.
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Developing a Framework for Effective
Communication with Older People
Ying Jiang, Hua Dong(&), and Shu Yuan
Tongji University, 1602 Zonghe Building, 1239 Siping Road,

Shanghai 200092, China
[email protected]
Abstract. Communicating with older people is more challenging because of

age-related cognitive and sensory impairments. How to develop an approach to
enable inexperienced and young designers to effectively communicate with
older people? A new and pragmatic framework is developed which aims to
identify key factors of communication techniques that designers need to learn.
This framework can help designers to decide which techniques are most relevant
for specific conversation situations. It can also be used to systematically collect
communication knowledge and skills as a designer’s personal communication
guidance.
Keywords: Effective communication Older people Cognitive impairments

Sensory impairments
1 Introduction
Effective communication between designers and older people is perhaps one of the
most critical elements of interview. Communication with older people can be made
more challenging as a result of age-related impairments. These age-related changes in
hearing, vision, cognitive and physical abilities make face-to-face communication even
more demanding [1]. The results of numerous surveys indicate that age-related cog-
nitive and sensory impairments highly affect communication. Many older people with
a vision, hearing impairment experience frequent communication breakdowns [2].
Between 30–50 % of 70 year-olds have a hearing loss that is sufficient to interfere with
conversations [3]. About 20 % of adults older than 65 years of age experience visual
difficulties that can limit clarity of a person’s face at a conversational distance [4].
About 6 % of adults older than 65 years of age exhibit combined hearing and vision
impairments (dual sensory loss) [5].
Older people-related communication barriers have been reported in design litera-
ture. Communication with users having speech or hearing problems can be difficult [6].
Interaction with older users often presents particular communication challenges for
designers. In many cases, designers are forced to rely on their own experience or
intuition to guide their assumptions about user characteristics, which may have little
relevance to the real situation [7].

DOI: 10.1007/978-3-319-20892-3_7
62 Y. Jiang et al.
Fig. 1. The transactional model of communication (Source: Adapted from [8])
In addition, designers with young minds and attitudes are often fashion lovers: they
pay more attention to trendy ideas, rather than the knowledge on older people. Very
few designers have had training or education in communicating with older people.
This paper presents a first stage of study that seeks to develop a framework, which
can help designers learn skills that will enhance their effectiveness in communicating
with older people with cognitive and sensory impairments. This study is organized as
follows: 1. To identify age-related cognitive and sensory impairments which are rel-
evant to communication; 2. To categorise key aspects of communication that can help
designers identify key factors for interacting with older people; 3. To develop a
framework to aid communication.
This framework of effective communication was developed based on the transac-
tional model of communication (Fig. 1). The model indicates each communicator is
both “the sender” as well as “the receiver” simultaneously. It takes into account “noise”
and the factors in communication. Noise is anything that interferes with the intended
communication. Time shows that communication changes over time as a result of what
happens between people. The outer lines of the model indicate that communication
happens within systems that both communicators share their personal systems. It also
considers changes that take place in the communicators’ fields of personal and common
experiences.
2 The Three Levels of Effective Communication
The most common deficiency in interviewing with older people remains a failure to
demonstrate empathic listening and responding. Empathy is the ability to see things
from the other person’s perspective. Developing empathic listening is particularly
necessary for understanding the deficits that impede communication with older people.
Developing a Framework for Effective Communication 63
Fig. 2. The three levels of effective communication
Empathic listening, according to Stephen (1989), is listening with intent to

understand. This kind of listening is not skill-based. It should not truncate from char-
acter and relationships. This means seeking first to understand, to really understand.
“The essence of empathic listening is not that you agree with someone; it’s that you fully,
deeply, understand that person, emotionally as well as intellectually. Empathic listening
involves much more than registering, reflecting, or even understanding the words that are said.
Communications experts estimate, in fact, that only 10 % of our communication is represented
by the words we say. Another 30 % is represented by our sounds, and 60 % by our body
language. In empathic listening, you listen with your ears, but you also, and more importantly,
listen with your eyes and with your heart” [9].
However, sometimes we thought we have fully understood what people said, but we
did not. An ideal communication requires people to eliminate their personal prejudice.
But it is rare and difficult, because we often cannot interact with people without our
personal view all the time.
Some people have extraordinary talent in empathic communication, but everyone
can learn to become a competent communicator. There are three levels of communi-
cation (Fig. 2): acceptable communication, empathic communication and ideal com-
munication. It is possible to learn the skills to conduct acceptable communication and
empathic communication (the gray parts in Fig. 2). The framework to be developed
later also addresses these two levels of effective communication.
3 Age-Related Impairments with Communication
Aging process is not a simple process of declining [10]. It is important to consider that
individual differences of communication skills do exist throughout the life span. But,
we should be aware that much remains unchanged along the aging process. For
example, there is no evidence of decline in most aspects of language abilities among
older adults, including the use of language sounds, meaningful combination of words,
and verbal comprehension [11]. When communicative differences between older and
64 Y. Jiang et al.
young adults have been observed, those differences have revealed that in some areas
the older perform better than the young [10].
However, communication with older people can be challenging as a result of
age-related cognitive and sensory impairments. Some age-related conditions such as
hearing loss, and diseases such as dementia and stroke, directly affect individuals’
ability to produce and process language, making communication itself problematic
[12, 13]. For instance, cognitive impairments can affect the quality and quantity of
linguistic capability; visual impairments will affect the ability to read, and to interpret
lip movements. They also affect the ability to detect and interpret other non-verbal
communications that accompany speech; hearing impairments can cause difficulties
with understanding verbal communication, and also generating speech [14].
Effective communication with these older people requires designers to have a thorough
understanding of older people’s capabilities and communicative difficulties (Table 1).
Designers may learn techniques to adapt to communication deficits of older people
with cognitive and sensory impairments. Developing empathy is particularly necessary
for understanding the physical deficits of older people that impede communication.
Cognitive changes in older adults are highly variable from one person to another
[11]. Dementia adversely affects people’s receptive and expressive communication.
Older people with memory loss have some difficulty with recall of recent activities or
events.
Vision is important for understanding non-verbal communication cues. Gestures,
lip reading, contextual cues, facial expressions and eye gaze are important non-verbal
elements to communication that may be missed by an older person with vision
impairment [2].
Hearing loss makes it difficult for older adults to understand and remember speech
in the presence of background noise, especially multiple competing conversations [11].
Older adults with age-related hearing loss often try to compensate by reading the
speaker’s lips. This is possible only if the older adult can see the speaker’s lips,
preferably at face level [11].
4 The Factors of Effective Communication with Older People
Effectiveness involves achieving the goals we have for specific interactions [8].
Effective communication is vital for the designer and the older people in obtaining a
successful and positive relationship, and allow them to have a satisfied interaction.
Here, within the design context, the term “communication” is narrowly defined,
referring only to designer-user face to face interactions within a work setting.
Assumptions are often made that because someone has chosen to design for older
people as a project, so they will have empathy when interacting with older people.
Sometimes this is not the case. Some designers appear to have the innate ability to be
empathetic; others may never have had these traits or with little respect and recognition
of the needs of older people. Even though we speak to older people with empathy,
sometimes even regarding older people as grandparents, we may recognize that we still
Table 1. Age-related cognitive and sensory capabilities and communication
Capabilities Communicative effects of Typical causes of

impairments communicative
difficulties
Cognition is the way we Cognitive impairments can - Distance (reduced visual
respond to sensory affect the quality and quantity angle)
perceptions of the world, of linguistic capability [14]. - Visible distraction
process them and choose As the Alzheimer’s disease - Poor illumination of
our responses. Cognition progresses, problems with partner’s face
Cognition
capabilities include visual perception and early - Low contrast facial

information on difficulties with language can features
perception, working emerge [16]. Changes such - Unfamiliar words
memory, long-term as: using familiar words - Complex sentences
memory, attention, visual repeatedly; inventing new - Partner’s rapid speech
thinking and verbal words to describe familiar rate
thinking. At a higher objects; easily losing his or - Partner’s unclear
level, the sensory, her train of thought; reverting articulation
cognitive and motor back to a native language;
functions of thinking are having difficulty organizing
integrated together within words logically; speaking less
the brain [15]. often [19].
Vision capabilities Visual impairments - Distance (reduced visual
include visual acuity for (Cataract, Age-related angle)
perceiving fine details, maculopathy, Glaucoma, - Visible distraction
contrast sensitivity for Diabetic retinopathy - Reflective glare
perceiving form, colour Hemianopia) will affect the - Poor illumination of
Vision
perception for detecting ability to read, and to partner’s face

the range of color used, interpret lip movements. - Low contrast facial
usable visual field for They also affect the ability features
seeing extents and depth to detect and interpret other - Partner’s rapid speech
perception for judging non-verbal communications rate
distances in three that accompany speech [14]. - Partner’s unclear
dimensions [17]. articulation [18]
Hearing capabilities Hearing impairments - Distance (reduced sound
include the ability to (Presbycusis, Cerumen level)
detect sounds at occlusion, Noise induced - Background noise
Hearing
different frequencies, hearing loss, Otosclerosis) - Room echo

speech discrimination can cause difficulties with - Partner’s low voice level
and sound localisation. understanding verbal - Partner’s rapid speech
communication, and also rate
with generating speech [14]. - Partner’s soft/high-
pitched voice [18]
- Partner’s unclear lip
movements
66 Y. Jiang et al.
Fig. 3. The designer-older people transactional model of communication
need to combine specific techniques, especially with those older people who have
cognitive and sensory impairments.
Therefore, designers need to learn how they transmit information and how to be
sensitive to those messages expressed by older people. We have to look for an
acceptable and efficient approach to achieve this goal by combining techniques and
empathy. Meanwhile, we need to remember to eliminate our prejudice as much as
possible. It should also be highlighted that listening is more important than speaking,
although communication is a two-way process.
First, we need to understand the designer-older people communication system
presented in Fig. 3, which is developed based on the transactional model of commu-
nication [8]. As we know, effective communication is an activity that depends on clear
expression and full comprehension of both sides. But in the interview, it is often the
designer who remains in control [20] because he/she collects data from the older
respondent. Therefore, it is the designer’s responsibility for choosing an appropriate
means for communication which can work well for both sides.
Designers’ interviewing older people is a conversation (speaking channel) that has a
structure and a purpose determined by designers. It is a research professional interaction,
which goes beyond the spontaneous exchange of views as in everyday conversations,
and becomes a careful questioning and listening approach with the purpose of obtaining
thoroughly tested knowledge about [21]. Ethical issues go through the entire process of
an interview investigation, and potential ethical concern should be taken into consid-
eration from the very start of an investigation and up to the final report [21].
A designer/an older person encodes messages (verbal/nonverbal), and then trans-
mits the message via a speaking channel to the other side, and then decodes the
message (verbal/nonverbal). The message may encounter noises, which interferes with
the decoding of messages sent over a speaking channel by an encoder (e.g., any
physical environment, psychological, physiological distraction or interference), which
could prevent the message from being received or fully understood as the sender
intended. The shared field of experience shows how communication becomes more
difficult when designers and older people have less in common.
From the Fig. 3 we can see designers could achieve effective communications
mainly through three means: i.e., 1. Increasing shared field experience; 2. Encoding/
decoding messages correctly; 3. Decreasing “noises”.
4.1 Increasing Shared Field Experience

Shared field experience is a common ground between a designer and an older person.
To share a common experience is helpful to understand each other, and can create trust
and security. Before interview, it is useful to gather preliminary data on user back-
ground; at the beginning of the interaction, engaging with older people in a brief
dialogue may help the designer to understand the culture background, personal expe-
rience of the older person. They can also assess the level of sensory impairments of the
older person.
4.2 Encoding/Decoding Messages Correctly

The designer encodes messages by using verbal/non-verbal ideas and thoughts
to process the information. The purpose for decoding is for the designer to be able
to comprehend the older person’s messages to his/her best of understanding. To
encode/decode messages correctly requires designers to be more attentive to both
verbal (i.e., words spoken) and nonverbal cues (i.e., the ability to express and interpret
facial expressions, body posture and movements, and vocal tones). This process should
not be conceived as a one-size-fits-all sets of procedures. It requires the designer to take
into account the diversities of older people. Every old person is special; designers need
to listen and respond to each one on an individual basis.
4.3 Decreasing “Noise”

Noise can be anything that prevents effective communication from happening.
• To exclude the negative influences on context (physical environment and time)
– Environment: eliminate visual and auditory distractions as much as possible. For
example, provide adequate illumination; eliminate reflective glare; visual dis-
tractions; and reduce noise and echo in the room.
– Time: to appoint an appropriate time and control the length of time. For
example, hearing worsen later in the day, morning appointments are generally
better for older people [22]; it is useful to consider their nap time and provide
frequent washroom times if possible.
• To isolate physiological noise
This requires an understanding of the capabilities of older people with cognitive
and sensory impairments.
68 Y. Jiang et al.
• To isolate psychological noise

Real communication barriers exist beyond linguistic. Designers’ attitudes and
behaviors can make older people unwilling to listen and talk. One of the most
important things to remember is to avoid ageism. Designers should regard each
older person as a unique individual with valuable experiences and treat them
respectfully. Designers need to express respect nonverbally and verbally as this is
the most powerful way to build a relationship. Moreover, if one wants to have a
really effective interpersonal communication, one cannot do it with techniques
alone. One has to build the skills of empathic listening on a base of one’s character
that inspires openness and trust [9].
• To avoid semantic noise
It exists when words themselves are not mutually understood. Sometimes the
designer creates semantic noise by using jargon or unnecessary technical terms. It is
better to use everyday language.
5 A Framework of Effective Communication
Any communication process can be divided into three stages: before, during, and after,
the communication. In the Fig. 4, before the communication, the designer should
collect the older person’s personal information, including cultural background, per-
sonal experience and capabilities. The designer also needs to be aware of the com-
munication context, to choose appropriate environments and arrange proper time, such
as providing adequate illumination, eliminating reflective glare and visual distractions,
reducing the environment noise and echo. During the process of the communication,
designers need to reasonably use verbal and nonverbal communication skills. At the
same time, empathic listening and responding should be applied from the beginning to
the end. After the communication, designers should summarize the feedback which is
provided by older person. It will tell the designer how well they have decoded the
message.
Fig. 4. A time process model of communication

The designer must know how to use verbal and nonverbal skills effectively when
he/she interviews older people with cognitive and sensory impairments. In the
framework (Table 2), the typical causes of older people’s communication difficulties
are listed in rows, and the verbal/nonverbal behaviors of designers are listed in
columns.
Table 2. A framework of effective communication with older people

70 Y. Jiang et al.
The framework can be used either as a checklist or as an information collection

tool:
(1) A checklist: The framework as a checklist let designer consider what communi-
cation techniques should be focused on before an interview; If any communica-
tion barrier occur, designers can correct their behaviors immediately by checking
the factor in the framework.
(2) An information collection tool: After the interview, designers sum up all their
communication experiences, using the framework provided. After accumulating
enough experiences, designers can create a personal communication guidance. As
a common framework, it offers flexibility to all designers, which could be shared,
augmented and personalized over time.
For example, in preparing for an interview with a visually impaired older person, the
designer can identify the important areas by mapping the links between communicative
difficulties of vision and verbal/nonverbal behaviors. And then write down appropriate
communication techniques in each area. After a number of interview practices, the
designer will enrich this framework as a systematic guidance full of communication tips.
Meanwhile, the designer needs to be more attentive to both verbal and nonverbal
cues of the older person. Designers could ask questions and paraphrase what the older
people said to clarify meaning. Furthermore, as we know, cognitive and sensory
impairments have considerable impacts on self-image and confidence. Many older
people are reluctant to disclose their cognitive, visual and hearing impairments.
Designers need to be sensitive to the behaviors that indicate the older person’s
impairments. For example, if an older adult is turning his or her head to one side, it may
be to adjust the visual distance or angle for improving vision to see you. If an older
person often asks you to repeat what you have said, he/she may have a hearing
impairment.
6 Conclusion
This paper is intended as a starting point for designers interested in understanding how
age-related changes may influence communication and how to effectively communicate
with older people with cognitive and sensory impairments. A framework provides an
acceptable approach to help designers learn communication techniques. However it is
not a panacea. Designers need to practice and find which strategies work best for them.
Different older adults have different communication needs, which may require different
techniques of communication. However, if we begin with this simple framework and if
we train ourselves, we will find increased effectiveness and satisfaction, and will
be able to communicate better with older people who have cognitive and sensory
impairments.
The framework will be further developed with designers to ensure that the cate-
gorization is as useful as possible, and will be tested with designers to improve its
usability and appropriateness.
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Music in the Retiring Life: A Review
of Evaluation Methods and Potential Factors
Mao Mao1(&), Alan F. Blackwell2, and David A. Good1

1
Department of Psychology, University of Cambridge, Cambridge, UK
{mm992,dg25}@cam.ac.uk
2
Computer Laboratory, University of Cambridge, Cambridge, UK
[email protected]
Abstract. People retiring now differ greatly in knowledge, motivation, attitudes

towards and use of digital music-related technologies to younger generations or
their predecessors. This paper reviews the methods that have been used to
investigate why people use music-related technologies, how they use them and
why. Using a lens provided by social cognitive theory it identifies future themes
for research into music and ageing. Hopefully, these analyses will inform
the design of future music related technologies for people at the transition to
retirement, and the elderly.
Keywords: Retirement Transition Music Social cognitive theory
1 Introduction
Life is full of transitions. Retirement is one such major transition, which results in
major differences in patterns of activity, sense of self, and social relations. These
changes are correlated with and often consequential for a person’s physical and psy-
chological well-being [1, 2]. The “individual’s normative role as an elderly person” [1],
may have an important impact on their attitudes and behaviours [3], at a time when
adopting and adapting to new leisure, voluntary and other social activities is important
for enjoyment and health. On such activity is community music, and many forms of
engagement with or enjoyment of music have been greatly affected by new
music-related technologies over the past decade and longer.
Even though older people are often stereotyped as being resistant to novelty, many
actually “continue and even increase their use of technology” [4], because they tend to
focus more on maintaining close relationship and personal life interests when they are
getting older. We define music-related technologies as all types of digital or mass
media technologies that are involved in music practices. For example, not only music
streaming services and digital instruments are included, but also traditional media
technologies such as TV, CD, and radio. Technology use by older adults has been
extensively studied by researchers from multidisciplinary areas, and in this paper we
will build on the work of Wagner et al., applying Social Cognitive Theory (SCT) as a
lens to view and organise the literature related to music-related technology use
behaviour of people at retiring.

DOI: 10.1007/978-3-319-20892-3_8
74 M. Mao et al.
Social Cognitive Theory (SCT), addresses “how people motivate and regulate their
behaviour and create social systems that organise and structure their lives” [5].
According to Compeau and Higgins, SCT is “based on the premise that environmental
influences such as social pressures or unique situational characteristics, cognitive and
other personal factors including personality as well as demographic characteristics, and
behaviour are reciprocally determined” [6]. In other words, there are important inter-
dependencies between these three domains.
In this paper, we adopt the Wagner framework and define Person as people who
actively engage in music activities at their transitions to retirement, Behaviour as using
digital media technology for music-related activities, and Environment as the social
context of group/individual music making and technological system.
1.1 Review Method and Definitions

For this review, we gathered articles from 2004 to 2014 by searching various databases
for peer-reviewed journal articulate and conference proceedings on the subject of music
and retirement. We used nine databases specifying gerontology and psychology
(PubMed, PLoS ONE), computer science (ACM Digital Library, IEEE), and multi-
disciplinary subject areas (Web of Knowledge, SpringerLink, ProQuest, Elsevier,
JSTOR). Search keywords include reference to retirement and ageing (age or ageing or
old or senior or elderly or retirement), music (music or music making or choir or
singing), technology (technology or media or digital technology). The total size of this
sample is 52 papers, covering the period 2004–2014. The following information was
analysed: the sample studied, methods, variables or constructs studied, research
questions, evaluation goals, evaluation measures, theory involved, and key findings.
Thus using Wagner’s Social Cognitive Theory (SCT) to organise the literature from
psychology, gerontology, as well as HCI and human factors, we first examine the
methodologies used and then the factors affecting the interaction between people at the
transition to retirement relevant to their use of music-related technologies. Thereby we
focus on the three reciprocal determinants: person, behaviour and environment. The
paper then concludes with a discussion of future themes of HCI studies concerning
music and ageing.
2 Methods to Understand Technology and Community Music
A common feature of the methods used in reviewed studies is that they often use
several different methods to “triangulate on a particular question” [7]. There are many
reasons to recommend this approach as it ensures that a study is not vulnerable to the
weaknesses of any single method. Nevertheless, we will consider the separate methods
independently so as to identify their value across this domain of interest.
2.1 Qualitative Methods

27 of the 52 papers use qualitative methods, ranging from interviews, focus groups,
qualitative survey, contextual observations, ethnographic studies, to diary journals and
Music in the Retiring Life 75
cultural/technology probes. Interviews (40.7 %) and qualitative survey (29.6 %) are the
most common used methods for understanding how people use technology to conduct
their music-related practices.
Interviews. Interviews are among the most widely used method [7]. When engaging in
a conversation with individual participants, interviewers have explored the intervie-
wee’s subjective opinion about the use of technology, and how they are influenced by
the social or technological environment. Interviews are conducted either in the inter-
viewee’s own place (homes, workplace) or in the lab environment. Compared to lab
environment, conducting contextual interviews at the participant’s place allow
researchers to better understand why certain technologies are used or barriers exist, and
provide an opportunity to see how environmental factors might have an effect. For
example, Vaisutis and colleagues explored the role of objects and social relations in
place through contextual interviews, then identified objects with different functional-
ities and how people attribute emotional meanings to them [8]. The interview is a
flexible and adaptable way of finding out the relationship between user, behaviour and
the environment. However, interview findings can be subject to a variety of errors
including participant recall [7], leading questions, and a desire to provide the answers
the interviewee believes the interviewer wishes to hear. This entails that high quality
interview data depends on the skill and experience of the interviewer [9].
Focus Groups. The focus group originated in market research in the 1920s, and is now
widely used in many fields of applied social research [9]. Examples include examining
exploring technology usage and attitudes among older adults [10], investigating older
adults’ motivation to adopt technological innovation [11], and how older people keep
in touch with friends and relatives [12]. Even though the focus group method is
efficient in obtaining the most important topics and flexible to conduct, it may produce
a false consensus in attitudes [9] and may not elicit confidential issues. Hence,
researchers who would like to use focus groups need to use other techniques to validate
the information generated by the group.
Diary Study. Diary studies allow participants to record their experiences as and when
they occur, and enable the capture of substantial amounts of data with much less effort
on the part of the investigator [9]. A diary could also serve as a proxy for observation
in situations which are hard to make direct observation [9], and might help to improve
the accuracy of participant recall [7]. For example, Salovaara et al. used diary-aided
interviews to investigate the interplay of technologies and transitions of people at the age
of 55–65 [13]. The concrete diary data provides use practices and communication circles
of participants within one week, and later serves as a means of generating specific
questions of interviews. It was identified that life interests at the transition stage were
always conflicting, forcing people to choose among “possible selves”. There are two
diary methods that are widely used in HCI. One of them is to keep the diary with “critical
incident”. This approach allows participants to record the “incidents that they perceive
to be important or critical in obtaining a satisfactory outcome” [9]. Another diary
method is known as “reflective journal”, where participants are asked to provide an
account of their experience in a particular situation, and a reflection on that experience.
76 M. Mao et al.
Ethnographic Study. Ethnography is growing in popularity as the first step in any

investigation. The virtues of ethnography in HCI are: (1) to make visible the context of
system usage, social practice that might not be encountered, and (2) to provide
exploratory frameworks for observed context to offer designers a view of interaction
between people and technology. In the field of technology and music, examples using
ethnographic study include how nightclub DJs mix tracks, collect music, prepare for
performances, conduct promotion and networking with the help of music technologies
[14], how older people understand their relationship with technology [15]. Ethno-
graphic methods are beneficial in observing the naturally “accountable” ways [16] of
the social context of use, real-life interactions and expectations [17]. However, the
richness of ethnographic findings are often set against concerns as to their validity and
reliability and depend greatly on the training and skills of the ethnographer. The latter
should always be borne in mind when using the results of such work.
Probes. The concept of cultural probes was introduced by Gaver et al. [18], originally
aiming at eliciting “inspirational material while avoiding the understood social roles of
researchers and researched” in design-oriented research. Example includes Leonardi
et al.’s work on investigating the functional and emotional geography of older adults’
domestic space [19]. An example of X probe (or technology probes) is the study
conducted by Rogers and colleagues on reframing the relationship in terms of wisdom,
creativity and invention among retired people. They used a Makey MaKey inventor’s
toolkit to engage retired people in the design-oriented workshop, asking them to invent
future technologies and suggest ideas for new technologies. Interestingly, the partici-
pants in this study were able to master the technology and collaborate in its use [20].
Probes provides open-ended, provocative, and oblique tasks which inspire design
responses, but are surprisingly regarded as non-scientific [21] giving their rich idio-
syncrasy. However, as Boehner et al. observe, the use of probes provides an alternative
way to encourage participative engagement between individuals, which can reveal
facets of an issue that traditional HCI methods have left unexplored [22].
Qualitative methods in our reviewed study typically follow either a data-driven or
theory-driven logic. In data-driven logic, bottom-up coding is used to derive themes
from the recorded transcripts, field notes, and verbal protocols. In theory-driven logic,
top-down coding is used to “identify existing constructs in a particular dataset” [7]. The
time-consuming process of qualitative data analysis can be assisted with computer aids,
e.g., key-word-in-context (KWIC), and qualitative data can be subjected to quantitative
analysis e.g., word frequency lists and category counts. However, whatever analysis
techniques are used, most writers using these techniques stares that it is essential to
return to the original text document to “validate the interpretation of themes derived
from statistical results” [9].
2.2 Quantitative Methods

While qualitative methods are valuable in developing a rich description of our target
population of retiring and retired people and how they vary in their use of technology,
the richness and local validity comes at a cost to our ability to generalise away from the
particular. This problem is addressed by methods that seek to deliver a broader if less
rich understanding from larger samples, and which offer quantified parameters to aid
our investigations.
Quantitative Surveys. Surveys are often used to capture user perception, their psy-
chological status, behaviour patterns, attitudes, and motivations. Surveys are not typi-
cally suited to exploratory work; but often build on good qualitative work to deliver a
focussed and substantial data set in a standardised form which facilitates comparisons
[9]. In the literature under consideration here, 29 % of the studies adopted questionnaire-
based survey as their primary research method. Two-thirds of them use surveys to assess
participants’ psychological status (e.g., quality of life, well-being measures, psycho-
logical needs, age-related symptoms), and just over half of them assess technology use
and relevant motivation and attitudes. A small subset of these (4 papers) conducted
cross-sectional or longitude surveys, in order to investigate the changes in participants’
psychological status or behaviour over time. For instance, Tamplin et al. measured
participants’ mood, visual analogue mood, cognition and global functioning, as well as
social functions at the 12th week and the 20th week after joining a community choir
established to support music therapy for elderly patients recovering from a stroke [23].
This study reported that singing in a community choir has positive effect on mood
and social engagement in such cases. Survey data collection is mostly done via
self-completion questionnaires, face-to-face and telephone interviews, although more
expensive to conduct permit the use of more complex item sequences and the possibility
of unstructured follow up questions to explore specific answers. Thus, general con-
siderations such as the questionnaire length, question complexity, close/open-ended
questions should be taken into account when designing surveys for late mid-aged and
older people.
Experimentation. Controlled laboratory experiment clearly provide the most infor-
mative way to evaluate if a certain intervention is successful [7], and it has been used
widely to evaluate the effects of music (training, performing) on psychological status or
the alleviation of symptoms. A fifth of studies in the papers under review here use
controlled experiments to answer such research questions. The tasks used can be
categorised into three groups: (1) behaviour tasks; (2) cognition and perception,
(3) collaboration. The performance-oriented tasks, usually involved a new/unfamiliar
technology/tool so as to test the possibilities of using the technology/tool freely and
safely. Tasks include gambling, information searching and multitasking with different
media. Time and accuracy were the most common measures used to assess perfor-
mance, and, behavioural and physiological measures such as gaze durations and eye
movement are also used in multitasking and searching tasks. Just over half the papers
(55 %) used cognitive and perceptual tasks and measures [24–27], such as auditory
Stroop task, Simon tasks, and [24, 28]. Outcome measures linked to psychological
well-being focussed on anxiety, dysphonia severity, cardiac and respiratory patterns,
mood states, and even immunological profile. A common focus for “community
music” is collaboration tasks where synchronisation tasks such as the drumming
experiment, body movement synchrony tasks, entrainment building, and resonance
within instrument are among the most frequently used paradigms [26, 29–31]. A good
example of this approach to the investigation of recreational music-making and the
78 M. Mao et al.
health of older adults is Koyama et al. which measured blood sample and mood state
during a series of synchrony tasks, finding that creative music-making does have
improvement effect in immunological profile and mood states in the older group [30].
Technology Logs. The recording of detailed logs from systems or applications that
participants are using is an effective method to gain an extensive source of quantitative
data. Technology logs reflect the a deeper analysis to actual use of technology [7],
compared to limited scenarios and data in controlled laboratory experiments or trials. In
the case of digital media technologies and music for late midage and older adults,
commonly used logs include system visiting rate [32], text comments, as well as
user-generated contents [33]. The log data can be further used in analysing psycho-
logical measures, such as psychological well-being [34], caregiver burden [7].
Experience Sampling Methods. A key issue for survey questionnaires that require the
recall of past behaviour is the various biases that can affect recall. An in situ measure of
behaviour, which avoids this problem, is the Experience Sampling Method (ESM). ESM
collects self-report experience throughout certain moments of interest [7] or at random
occasions during the day [35]. In the case of HCI and ageing, there are two ways of
collecting experience through this kind of sampling: (1) participants have to either
complete a questionnaire immediately after they interact with the system; or
(2) behavioural parameters (e.g., limb positions, right hip positions) or physiological
status (e.g., eye movement, mood status, heart rate, respiration, ECG, skin conductance)
can be collected at key moments. Researchers tend to use ESM to assess user experience
in context-aware situations often with the use of embedded sensors [36]. This method
has benefits in gaining in situ “observation” results, which are hard to obtain outside lab
settings; but they can be burdensome to some participants and necessarily might “miss
important activities” [36]. There is no use of ESM in our surveyed studies. Taruffi &
Koelsch’s work on mood experience with sad music mentioned that the validity of their
study could be potentially improvement if ESM were used [35]. Their use offers an
important additional avenue for research in this area.
3 Key Influencing Factors
Together these studies focus on three different factors, the nature of the persons
involved; their behaviour; and their environment.
3.1 Person
Given our focus on retirement the persons being considered are typically late middle
age and older adults who engage in music activities (individual or community-based)
with a focus on their physical, emotional and cognitive aspects of personal attributes.
The musical background of those studied is extensively addressed.
Key dimensions of music background include musical expertise, length of music
training (e.g., instrument, vocal), music practice style (e.g., long-term or short-term).
Existing studies have identified the positive relationship between music background
and psychological well-being, cognitive abilities, and quality of life [24, 28, 37]. There
have been an increasing number of HCI studies focusing on the experience of amateur
musicians, since this group of users are “serious about their leisure” and are “distinct
from the professional as from the novice and hobbyist” [38]. The relationship between
music background and wellbeing appear to combine with personality traits [39].
Researchers have investigated the relationship between trait empathy and the sadness
perception of people who listen to music, with the finding that empathy contributes to
the evocation of sadness via appraisal and nostalgia - which in turn are related to
well-being factors [35].
Another bunch of factors affects engagement or adoption: perceived benefits, prior
similar experience, and self-efficacy [10, 40–42], mono-chronicity [43], self-construal
are among the most frequently mentioned factors. Three forms of self-efficacy -
technology efficacy, information efficacy, and connective efficacy – may influence
one’s desire and confidence to engage in community music or accept related tech-
nologies [44].
3.2 Behaviour
Unsurprisingly, people at the transitions to retirement tend to use computer and the
Internet to a less extent than the younger generation, but spend more time on
face-to-face activities like community music making or connection to close relation
ships (e.g., relatives and good friends). The most extensively studied technology use
for older people is communication and social support [11, 45–48]. Different types of
communication technologies include email, telephone, text messages, social network
sites, and online forums or blogs, to provide specific support.
Individual music-related behaviours include music listening [35, 49], managing
music crates (both physical and digital), self-promotion [14]. Social music-related
behaviours include music-sharing [50, 51], community singing [23, 26, 27, 30, 37, 40,
52, 53], and collaborating with other musicians [14].
3.3 Environment
Environmental factors can be cast along two dimensions: artefacts and socio-musical
environment. The artefacts dimension refers to the instruments, devices, hardware and
software systems related to music that users are using. In our reviewed studies, artefacts
include instruments, sheet music, lyric sheets, as well as MIDI files used for learning
and archiving. Technology systems include media devices (e.g., MP3, radio, TV,
computer), the Internet services (e.g., music streaming services, social network sites,
personal websites, video gaming), computer-mediated communication technologies
(e.g., telephone, email, video camera, smart phones, cell phones), as well as music-
making applications (e.g., Sibelius, synchroniser, GarageBand, etc.) The socio-musical
environment dimension especially applies when more than one person is involved
(e.g., sharing music with friends, engaging in a choral life). Usability of the artefacts
has been found to have a direct correlation with adoption and decreased cost, and
further, engagement in the community [54] (Fig. 1).
80 M. Mao et al.
Fig. 1. Triadic reciprocal relationship of influencing factors on music and ageing
One important scenario in socio-musical interaction is group music-making. Such

groups always develop shared social habits naturally, which is known as “chameleon
effect” [55]. Firstly, the role (e.g., conductor, or chorister) that people undertake in
group music-making impact their experience. As a chorister, the kinaesthetic rela-
tionship with the conductor will reinforce or undermine individual’s habits for reaching
the consensus condition. Second, learning style (e.g., singing by ear or sight reading)
requires different memory modals (e.g., aural memory, kinaesthetic memory, factual
memory), which in turn impacts experience in music-making and relevant technology
use. Third, a strong group identity can lead to a greater number of member contribu-
tions and build stronger ties among members [44].
4 Conclusion
In this paper we have examined the literature on music-related technology use by

people who are at the transitions to retirement through the lens of Social Cognitive
Theory. Through this approach when can see that the personal characteristics at the
retiring age, their use of music-related technologies, as well as the technologies and
socio-musical environment exist in a triadic reciprocal relationship. Although there has
been extensive research addressing the use of technologies among people during late
middle age and older age, there are still many opportunities for further study in
addressing this field through the lens of music and life transitions. We hope that this
study will draw attention to this specific area of study and provide researchers with a
foundation upon which future knowledge can be built.
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Collecting Old People’s Data for More
Accessible Design: A Pilot Study
Weining Ning(&) and Hua Dong
College of Design and Innovation, Tongji University, Shanghai, China

[email protected]
Abstract. Good design should be equipped with the quality of being accessible
to broad user groups, including older people. As the population becomes older,
the needs and capabilities of people become ever more diverse. However, there
exists limited effective data for designers to understand older people’s capability
condition. The lack of good data becomes a great barrier to make design
accessible to older people. This paper introduces a pilot study of collecting older
people’s multiple capability data in China. It aims to explore principles and
instructions to design the process, methods and testing tasks of such a study. The
results show that in the pilot study, (1) there are discrepancies between users’
self-assessment and performance measurement, (2) the selection of products
should take into account the cultural context, and (3) ceiling effects exist and
they greatly affect the validity and reliability of the data.
Keywords: Accessibility Inclusive design Multiple capability Data

collection
1 Introduction
Successful design with good accessibility to a wide range of people requires in-depth
understanding of the user, from the designers’ perspective, knowledge about (1) users’
capabilities, needs, and aspirations, (2) different scenarios that people will use products,
systems and services, and (3)other factors include psychological, social, economic and
other considerations should be identified [1]. In the context of a rapidly-aging society,
the philosophy of inclusive design is given accumulating consideration. As the pop-
ulation becomes older, the needs and capabilities of people become ever more diverse
[2], Neerincx et al. classify users’ abilities form a product-usage perspective [3]:
• Sensory abilities such as seeing, hearing, touch, taste, smell and balance.
• Physical abilities such as speech, dexterity, manipulation, mobility, strength and
endurance.
• Cognitive abilities such as intellect, memory, language and literacy.
• Allergies can also be a significant factor in some products.
The necessity of user database, which contains users’ capabilities and contextual data, is
raised to help designers to understand the nature of this diversity. A person’s multiple
capabilities can reflect individual’s ability to operate or interact with products and the
breadth and multivariate nature of capabilities can be best captured and represented

DOI: 10.1007/978-3-319-20892-3_9
Collecting Old People’s Data for More Accessible Design 85
through a database that covers multiple capability domains for a representative sample
of the population [2]. Such databases that include users’ multiple capabilities infor-
mation are also expected to help designers in different design phases, e.g. to get con-
ceptual inspiration, to better understand users or to explore references to the prototype.
The current sources of regulated databases that designers can reach are almost
ergonomics data, especially anthropometric data. However, there are many ‘gaps’ in
the ergonomics data available to designers. For instance, in a study conducted by
Nickpour and Dong, the results show that ‘all interviewed designers considered the
existing anthropometric data out of date and seven out of ten believed the data was
irrelevant or not applicable to their specific field of design practice. The data was also
reported as being unreliable, not appealing and confusing’ [4].
To plug the gaps between existing databases and designers’ requirements, studies
have been conducted to collect capability-related data, but varied shortcomings
emerged [2]:
• Databases tend to focus on a specific domain of capability, and every single survey
is based on a specific sample, a product interaction often covers more than one
capability, thus it is unreasonable to refer to data from different samples.
• Some studies have captured multiple capabilities, but insufficient information was
unable to be applied in supporting a practical use.
• In sampling, the sift criteria often exclude specific population groups and often
cannot represent the whole population.
• Very few databases include data of older people.
• Most studies were collected from western countries [5].
Additionally, technologies develop rapidly, people are always adopting new products
and services, so studies based on out-of-date scales or users’ habits are no longer
applicable to the new context of use. Stephanidis et al. [6] state that in the context of the
emerging Information Society, we are meeting a global requirement of coping with
diversity in the ‘scope and nature of tasks’ in using products.
This paper describes a pilot study that collects Chinese older people’s capability
data. The main methods of the survey were derived and adapted from Towards Better
Design [7], which was initiated by the University of Cambridge. That study has gained
good results in gathering information of the whole age range among UK population. As
a pilot study, the main aim of our survey was to verify the feasibility of this foreign
study in a new background (i.e. new context and a specific target respondents: older
Chinese people), as well as to explore possible factors that affect the conduct of such a
survey and to conclude principles or instructions for establishing an effective older
people’s database for designers in the future.
2 Methods
This pilot data collection study was conducted through a comprehensive questionnaire
that contains questions as well as actual testing tasks. On one aspect, respondents were
asked to verbally report some information, on the other aspect, actual performance tests
were employed through three different granularities of measurements [8]:
86 W. Ning and H. Dong
• Component function (such as grip strength test).

• Activity (such as reading the LCD screen on a mobile phone).
• Task (a product interaction that integrates number of functions and activities).
The testing items of this study were derived from the technical report of Towards
Better Design with adaptations after translating the report into a Chinese version to
cater for the new context and to explore insights that may emerge when employing
such a survey on Chinese older people. The main adaptations were: (1) the wording and
expression of the statements were modified to make it more accessible to Chinese older
people and to prevent ambiguous statements and questions. (2) Testing items that
involve English language (letters, numbers and words) need to be listened, read or
cognized by the respondents were all replaced with Chinese. (3) Some products in the
tests were replaced with other products to suit Chinese older people.
The survey collects the following information from each respondent:
1. Age, gender and basic household information
2. Health condition
3. Vision
4. Hearing
5. Dexterity
6. Mobility
7. Reach and stretch
8. Cognitive function
9. Technology use and experience
10. Product use
11. Physiological resources
12. Interface style experience
13. Anthropometrics
14. Demographics
Pretests were conducted with three older persons to refine the questions and to evaluate
the time of the whole process. Finally, the expected time was set 1.5–2 h. Seven
interviewers received training and observed the pretests.
3 General Results
The respondents’ age range from 50 to 80. Finally, 70 sets of valid data were collected
from seven different towns and cities of China. The mean age of the samples was 64
(SD = 8.9). Basic information of the respondents is shown in Table 1.
As a face-to-face survey, it was well balanced in the quantity and quality of the
inquiry. When applied in China, new issues and problems emerged in a totally new
context. What should be emphasized is that the expected result of this study is not just
data collected, but also the assessment of the methods and items setting applied in this
survey.
After the collected data were converged, all the interviewers involved in the actual
survey gathered together to assess the process and content of the survey, and the defects
Table 1. Basic information of the respondents

Age 51–60 61–70 71–80 All
(N = 3) (N = 2) (N = 18) (N = 70)
Gender
Male 47 % 55 % 61 % 53 %
Female 53 % 45 % 39 % 47 %
Education
No qualifications None None 6% 1%
Primary school 10 % 41 % 28 % 24 %
Junior middle school 30 % 32 % 33 % 31 %
High school 33 % 18 % 17 % 24 %
Secondary technique school 7% 5% 6% 6%
Junior college 10 % 5% None 6%
Bachelor degree 10 % None 11 % 7%
Living arrangements
Alone None None 6% 1%
With partner 80 % 64 % 66 % 71 %
With children 20 % 36 % 28 % 27 %
Rural/Urban
Urban 60 % 46 % 61 % 56 %
Rural 40 % 55 % 39 % 44 %
were put forward. First, sample bias emerged in the process, i.e. specific population
groups were excluded (e.g. illiteracies and people who were unable to speak mandarin
or their regional dialects were too difficult for the interviewers to understand). Sec-
ondly, the options of the questions in the same nature are not unified, both in the
amount and the way of presentation, which has negative impact on the respondents’
comprehension to the questions. Thirdly, wording and expression of the statements still
need to be refined, and fourthly, there are some problems regarding the items settings
of the survey, which will be discussed in the next session.
4 Discussion
4.1 Self-Reporting vs. Performance Test
The methods applied in this pilot study were self-reporting and performance test. The
correlations or discrepancies of the results were expected to give instructions to
determine a more reasonable and effective way for the corresponding items in future
research. This could lead to a new structure of a user’s comprehensive data collection
work in a large-scale survey, i.e. on the premise of quality assurance, a specific
capability data could be obtained just through self-reporting or performance measures,
or through a mixed methods, so that the cost of such a survey could be reduced.
Additionally, such a comparison may also reveal some shortcomings of this study, so
that some new data collection questionnaires, devices or methods could be explored.
Fig. 1. Visualized general heath condition self-assessment (left: Male, right: Female)
In our study, we found some discrepancies between self-reporting and performance

tests. Figure 1. depicts the stiffness, pains or other uncomfortable conditions of the
respondents; they were asked to mark any problems specified on the diagram. After
overlaying all the collected results, we can see that male respondents tend to report
more problems on phalangeal joints and wrists, but the performance test shows that
there is no significant difference between male and female respondents (right hand:
Sig. = 0.886 > 0.05; left hand: Sig. = 0.585 > 0.05).
In the memory test, 25.7 % of the respondents reported that their daily lives were
“not at all limited” by their memory, but 34.3 % of them had lower performance than
the average in actual test.
Fors et al. summarized the advantages and disadvantages of self-reporting and
performance test [9]. Self-reporting offers a more inexpensive and easily-executed
means to obtain information, and it can be realized through flexible means, including
face-to-face survey, telephone and email, additionally, proxy survey could be carried
out if the respondent was not able to participate in some special situations. However, its
shortcomings are obvious: the reliability of self-reporting is often questioned and the
results are firmly correlated with social and cultural factors, and they are sensitive to the
change of these factors. Milanović et al. suggested that the indirect estimation of old
peoples’ physical ability levels via questionnaire rather than actual measurement tend
to lower the study’s reliability [10].
Compared with self-assessed measures, standardized performance tests have clear
face validity for the task being performed, better reproducibility and are less sensitive
to cognitive impairments and sociocultural factors [9]. Nevertheless, results from our
study imply that a respondent may perform a test very well, but he or she does face
some actual difficulties in daily life, at the same time, the environment can also affect
respondent’s performance.
Related studies indicate that considerable discrepancies exist between self-reported
limitations in function in independent activities of daily living and actual physical
impairments. For instance, persons characterized by current joint pain or stiffness,

using prescription medications, staying in urban dwelling, in depression, being female,
lacking memory, having arthritis, and lack of exercise, were more likely to report
higher levels of disability [11].
The reasons that lead to such discrepancies are complicated; significant portions of
variance in self-reported disability can be explained by demographic, cultural, social
and psychological variables such as gender, familiarity with testing activities,
depression and helplessness [12–14].
It should be noticed that, form a designer’s perspective, the differences existing in
users’ self-assessment and actual performance may offer some valuable insights for
them to better understand the users or find a ‘design chance’. These ‘gaps’ can also be
‘opportunities’ for both researchers and designers.
As a result of the limitation of the item setting, we do not acquire enough data to
compare the correlations and discrepancies of every specific capability, but the prin-
ciples of related research are clarified to some extent: some categories of users’
capabilities can be obtained just through self-reporting, at the same time, capabilities
that are correlated with users’ sociocultural factors should be collected through inte-
grating self-reporting and performance measurements to achieve the reliability and to
offer insights to designers.
4.2 The Selection of Products

Users’ capability of operating and interacting with products can provide direct refer-
ence for designers, in this pilot study, product-operating related testing items were both
involved in questionnaire and actual performance tests.
One fundamental issue is what kind of products should be adopted in such a survey.
Older people may be exposed to many specific products in their daily life. Chen et al.
summarize comparatively intact product categories that are involved in the elderly’s
daily living, based on different technologies, the products are classified into five cat-
egories [15]:
• Housing and daily living, with the functions of convenience, safety, security,
comfort and entertainment.
• Communication technology, with the functions of communication and transfer
information.
• Mobility and transport, with the function of compensating or preventing physical
limitations in personal mobility.
• Health technology, with the function of home healthcare and medical assistance.
• Education and recreation, with the functions of education and entertainment.
It is undoubtedly unrealistic to bring a detailed range of products that contains all the
specific devices. But it may provide a clear structure and practical instructions to select
representative products for a capability survey.
Two main categories of products were employed in our pilot study: (1) common
housing products (chairs, bottles, keys, etc.), and (2) technology products (i.e. a smart
phone with touch screen). The implications can be discussed from two aspects.
First, the selected products should ensure enough angles, the new trend and
development of related technologies and their application on products are necessary to
be taken into consideration. For instance, mobile phones are very commonly used
among older people, in our study, 95.7 % of the respondents own at least one mobile
phone, and 64.3 % of them use it “frequently”. Previous studies on older people’s use
of mobile phone mainly based on a feature phone (normally with physical keypad and
cannot download and run applications) rather than a smart phone. It is reported that
China has been the biggest country smart phone assumption, and for the elderly, they
are also in the context of the transition from feature phones to smart phones, especially
for the ‘future’ older people, that means difficulties with smart phones that younger
adults encounter now may be encountered by older adults in the future when using
smart phones [16].
This big change profoundly affects the selection of products in such research;
naturally, it may directly determine the detailed testing items of the survey. For
example, existing research based on feature phones shows that older adults were more
likely to get lost in the hierarchical menu of mobile phones than younger adults [17],
however, the mainstream of smart phones now all adopt a flatting menu structure, in
our survey, we have found that only 15.7 % of the respondents failed to executed the
Interface Style Experience task (i.e. finding a specified menu icon).
Zhou et al. described the effects of this transition through three aspects: (1) what
used to be important in feature phones (e.g., font size, icon size) is no longer so
important in smart phones; (2) what used to be not so important in feature phones (e.g.,
connectivity) becomes important in smart phones; (3) what used to be important is still
important, but it is in different embodiments (e.g., ease to find the desire functions, ease
to get help, soft keys & multi-tap) [16].
Secondly, the gaps of products using between different subgroups of the elderly are
reducing but still exists. We found that gender and rural-urban differences, additionally,
the North and South differences, which are also addressed in most demographic-related
research in China, do not have distinct effects on the purchasing, using and perceived
difficulties of common housing and daily living products, but there are significant
differences in communication technology products.
For instance, we raised a hypothesis that, because older people in urban and rural
areas have different living habits and may conduct difference daily activities, they may
show differences in product use. The statistical analysis results show that there is no
significant difference (Sig. > 0.05) between these two groups in the using frequency of
‘calling on a mobile phone’ and ‘operating TV remote control’, but in ‘taking photos’
and ‘sending text message’ we can observe significant differences (Sig. < 0.05). The
corresponding perceived difficulties of the products, however, had no significant dif-
ferences (Table 2). The reasons behind this phenomenon are not clear, we believe that it
could be partly explained by the difference of education situation: in our research, the
urban respondents’ educational levels are generally higher than the rural ones. This
may imply that a standardized and unified setting of housing and daily living products
in a capability survey is acceptable and reliable, while products that correlated to
respondents’ cognitive capabilities should be chosen carefully.
Table 2. Significant difference between urban and rural in frequency of use and
perceived difficulties in product use.
Items Call on a Send text Take photos using mobile phone Operate
mobile phone message or digital camera TV remote
control
Frequency 0.13 0.05 0.01 0.47
of use
Perceived 0.73 0.43 0.16 0.89
difficulties
4.3 Ceiling Effects

The elderly’s capabilities present great diversity, specifically, an old person’s perfor-
mance are affected by his or her health condition, background, experience, etc.
Research has shown that the results of a physical function measurement study is limited
by a ceiling effect, i.e., the majority of the sample, especially the younger groups,
neither report nor exhibit disabilities. This, in turn, makes it difficult to attain statistical
significance in the analyses [9].
In our study, ceiling effects obviously affect the test of technology products. More
than half of the respondents have never or rarely used the products specified, and it
results in a great data missing in the following perceived difficulty tests (Table 3).
To reduce the ceiling effects, older peoples’ characteristics and preferences should
Table 3. The Proportion of respondents who never or rarely use the specified products
Items Use Listening to MP3 tracks on a Play games on PC or Use
internet portable device mobile phone GPS
The proportion of 61.4 % 71.0 % 65.7 % 91.4 %
“Never”
The proportion of 7.1 % 11.6 % 7.1 % 1.4 %
“Rarely”
be addressed to adapt the current items and scales. For instance, Jones et al. find that
older adults are more likely to seek health information, make purchases, and obtain
religious information, but less likely to watch videos, download music, play games, and
read blogs online [18]. That means applying some so activities or products that are
common to general users in a survey focusing on the elderly is unreasonable.
5 Conclusions
Based on the results of this pilot study, some significant influencing factors in a
multiple capability data collection survey are raised. First, there exists discrepancies
between users’ report and their actual capabilities; capabilities that correlated with
users’ sociocultural factors should be collected through integrating self-reporting and

performance test to get the reliability and offer insights to designers. Secondly, prod-
ucts involved in this research should ensure multi angles, and address the gap of
products using between different subgroups of older people. Thirdly, to reduce the
ceiling effects, older peoples’ characteristics and preferences should be addressed in the
survey.
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Time Reduction Design Method for Cognitive
Assist Technology
Junji Ohyama(&), Nana Itoh, Kenji Kurakata, and Ken Sagawa
National Institute of Advanced Industrial Science and Technology,

1-1-1, Higashi, Tsukuba City, Ibaraki 305-8566, Japan
{j.ohyama,nana.itoh,k-kurakata,ken.sagawa}@aist.go.jp
Abstract. Given the importance and abundance of current visual information,

visual display designs should consider their accessibility to elderly people.
However, adapting designs not only to young users but also to older users is
difficult because the difference in perception and cognition between these age
groups remains unclear. In order to solve this accessible design issue, we
introduce three studies: a study on the effect of aging on visibility, the con-
struction of a database containing the sensory characteristics of older persons
and persons with disabilities, and experimental and conceptual studies of our
proposed design method, the time reduction design. The time reduction design
method can solve the cognitive problems of aging societies by improving both
spatial visibility and recognition speed.
Keywords: Vision Time design Cognitive technology Experimental

psychology
1 Introduction
Important signs, user interfaces, and other visual information should be designed in a
way that can be read and understood by all users. Designers can create user-friendly
visual designs by drawing upon their experience and existing design methods. How-
ever, a substantial number of these designs are adapted only to young users. The United
Nations reported that the percentage of elderly people in most industrialized countries
will be 30 % or greater by the year 2050 [1]. Therefore, designers should consider the
ways in which their designs will be read and understood by elderly people. However,
adapting designs not only to young users but also to older users is difficult because the
difference in perception and understanding between the young and old remains unclear.
The goal of our study is to complete this data in order to obtain accessible designs.
Three studies are presented as solutions to the issue of accessible design. Part 1
discusses experimentation that was performed in order to study the effect of aging on
visibility. Part 2 constructs a database that contains the sensory characteristics of older
persons and persons with disabilities. Lastly, Part 3 analyzes the experimental and
conceptual studies of our proposed design method: the time reduction design (TRD).

DOI: 10.1007/978-3-319-20892-3_10
Time Reduction Design Method for Cognitive Assist Technology 95
2 Part 1: The Effect of Aging on Visibility
In the introduction, we discussed the experimental studies conducted on the effect of

aging on visibility. The elements of visual signs that enhance visibility are size, shape,
color, and contrast. Therefore, we examined the effect these visibility factors have on
both the young and elderly.
2.1 How to Examine the Effect of Aging on Visibility

In order to examine visual perception data, we primarily used general psychophysics
and experimental psychology methods. However, some considerations are necessary in
the study of aging, especially as they concern the measurement and analysis of aging
data.
One of the elements that must be examined when studying the effects of aging is the
age of the participants. The experiment must be designed in a way that examines the
differences between age groups. The most conscientious way to do this includes
recruiting participants from each decade, i.e., participant ages should range between 10
and 70. We used this method to study the effects of aging on basic visual functions,
such as visual acuity and spectral sensitivity. The results showed two types of aging
change, the linear and sigmoidal types, which had previously been observed in the
aging change of other visual functions. Therefore, if the purpose of studying aging is to
create accessible, user-friendly visual designs, only two age groups must be studied: the
younger and the older. If the proposed design system applies to both younger and older
users, the system’s visual design will also apply to users between these two age groups.
In our other studies, we compared two age groups (20s and 60s) and estimated each
aging trend by complementing data between the two groups.
Another element that can be explored is the medical history of ophthalmological
surgeries. In order to calculate the effect of aging on visibility, we can separate par-
ticipants according to eye surgery experience, such as surgery for cataracts. In our
studies, we recruited people who had not received eye surgery.
To calculate the effect of visual design features on visibility, the difference in
individual basic visual acuity must be addressed. We measured the visual accommo-
dative power of each participant using an auto refract meter and corrected individual
vision to the topmost visual acuity for given test distances using an optometry lens.
When applying the results of vision studies to display design, we regarded not only
the participants’ average but also their distributions are meaningful. For example, in
some cases, the acceptable visibility level of the 80 % of the 60s population was more
practically meaningful than the average level (i.e., 50 % of the population). In order to
enable this analysis, data must be collected from a substantial number of participants.
In our research, we enlisted approximately 100 participants for each study. Table 1 lists
our investigations concerning the effects of aging on visibility.
Using these results, we developed methods for evaluating and improving accessible
visual design not only for the young users but also for older users. For example, we
calculated the minimum legible font size and proposed a legibility estimation formula
that depends on age. In order to obtain an elder-friendly accessible design, the visual
96 J. Ohyama et al.
Table 1. Examples of the effect of aging on visual perception

Studied aging Participant age groups Relative examined conditions in addition
effects on visual characteristics (Number of participants) to age
Legibility of font size 20–29, 60–79 (90) Viewing distance, Environmental
illumination, Font type, Letter
complexity
Legibility of letter contrast 18–29, 60–83 (108) Size, Viewing distance, Environmental
illumination, Contrast polarity, Font type,
Letter complexity
Spectral sensitivity 10s, 20s, 30s, 40s, 50s, Target color, Background color, Luminance
60s, 70s (91) contrast
Useful field of view 20–29, 60–79 (98) Target size, Target color, Target luminance,
Target, direction, Background color,
Environmental illumination
Contrast sensitivity 10s, 20s, 30s, 40s, 50s, Environmental illumination, Duration of
60s, 70s (110) target presentation
Readability of text 20–29, 60–79 (36) Kerning, Leading, Viewing distance, Font
type, Font size
Ability of categorization of colors 20–29, 60–79 (89) Target color, Environmental illumination
functions of older people must be considered when selecting color, contrast, and size.
The data for these visual characteristics have been used to establish the international
and Japanese standards [2, 3]. We are also preparing another proposal of the related
guidelines to present to the international standards.
2.2 Legibility Data

A typical study on aging includes its effect on the minimum legible font size. We
measured the effects of aging on the minimum legible font size under multiple con-
ditions, including distance, luminance, font type, and characters, assuming that the
characters were written in black on a white background. The results for one of these
experiments are shown in Fig. 1.
Additionally, we used these results to estimate the minimum legible font size of one
character for a person of a given age with a given viewing distance, luminance, font
type, and characters. This estimation equation can be written as
P ¼ a ðD=V Þ þ b ð1Þ
Here, D represents the viewing distance in meters, V is the visual acuity, P is the
estimated minimum legible font size, and a and b are coefficients decided by the font
type and letter complexity. For example, in order to estimate the minimum legible font
size of Gothic font numerals, we have a = 6.4 and b = 3.0 (see [4, 5] for other
conditions). Visual acuity is related to environmental illumination and age. Therefore,
V is estimated using the target user’s age and environmental luminance, and we can
estimate the minimum legible font size and preferred legible font size using this for-
mula or gathered data in order to improve legibility.
Fig. 1. Minimum font size required to read a single Japanese letter (hiragana/katakana/numerals,
kanji 5–10 strokes, kanji 11–15 strokes) with viewing distances 0.5 and 2 m and luminance levels
100 and 0.5 cd/m2. (a) Results of 48 younger participants. (b) Results of 44 older participants.
(Figure provided by [4].)
This estimation formula was used to establish the JIS S 0032: 2003 Guidelines for
the elderly and people with disabilities—Visual signs and displays—Estimation of
minimum legible size for a Japanese single character [3], which has been proposed to
the International Standards Organization (ISO).
3 Part 2: Development of Interactive Database for Accessible

Design Assistance
In Part 1, we suggested some practical considerations when examining aging effects on

visual perception. We also explained how to apply the data in order to evaluate and
improve design accessibility. These data and evaluation methods are useful to designers
who are familiar with their technical terms and academic data; however, they remain
difficult for most laypersons to comprehend. In addition, accessing reports and guides is
difficult. Therefore, we developed an interactive online database, which has a simple
graphical interface, using the visual characteristic data explained in Part 1. The data-
base graphically describes various sensory characteristics using equations and tables,
and it also presents preferred designs based on the target users’ information and
environmental settings, such as age, viewing distance, and luminance. A sample
application of this database can be seen in Fig. 2.
Not only is the minimum legible font size calculated but also eight estimations
concerning age-rerated visibility characteristics. Table 2 exhibits these database items
and the corresponding effects of aging on vision. We also examined age-related
changes in auditory characteristics (see [6, 7]). Moreover, we are cooperating with
other researchers and institutes in order to link their reports and studies in our database,
compiling a worldwide guide for accessible design. This constructed database has been
released charge-free to the public on our institute’s website [6].
98 J. Ohyama et al.
Fig. 2. Example from the database of sensory characteristics of older persons and persons with
disabilities: input to the left; calculated results and corresponding examples to the right.
Table 2. Database items and supporting experimental data for the effects of aging
Design items Supporting experimental
data
Estimation of minimum legible font size Legibility of font size
Size and contrast threshold for legibility Legibility of letter
contrast
Age-related relative luminance Spectral sensitivity
Age-related changes of visual field size for detection: size of visual Useful field of view
field & detection rate
Contrast sensitivity function Contrast sensitivity
Preferred kerning and leading of text and sentences Readability of text
Color combinations based on fundamental colors Ability of categorization
of colors
4 Part 3: Time Reduction Design for Accessible Design

and Future Cognitive Assist Technology
In the final part of this paper, we introduce the conceptual and experimental studies of
our proposed design method: the time reduction design.
4.1 Time Reduction Design Concept

Previously, we discussed studies concerning the effects of aging on visual characteristics
and a method for using this data in order to improve design. For example, the visibility
of visual information and signs can be improved using the spatial characteristics of
vision that change with age, such as shape and color, found in our database. However,
the improvement of spatial visibility is not sufficient for the creation of useful visual
signs because most signs dynamically change, and their everyday recognition has time
constraints. Designs that enable fast, accurate recognition are necessary in an aging
society that is flooded with information. Our time reduction design (TRD) method can
solve the cognitive problems of aging societies by improving not only spatial visibility
but also recognition speed [8–10].
Assisting Recognition Speed for Fast, Adaptive Control Using the TRD.
Improvements made using the TRD method have the potential to save lives. Elderly
people are often the victims or victimizers of accidents caused by a lack of available
recognition time. For example, the number of careless car accidents perpetrated by
elderly drivers is increasing in Japan [11]. Drivers must quickly and accurately rec-
ognize multiple signs while driving. However, the time required for older drivers to
recognize visual information is not considered when signs are being designed or
arranged. Some of these careless accidents could be related to the decrease in older
drivers’ recognition speed.
Assisting Recognition in Time-Pressured Situations Using the TRD. It has been
argued that the evacuation delay of elderly people in Japan was one of the factors that
increased the number of flood victims [12]. Emergency signs and evacuation maps do
not take into account the recognition speed of elderly people. The TRD can transmit
information quickly and accurately to all people—both young and old alike—in
time-pressured situations.
Assisting the Personalization of Individual Cognitive Abilities Using the TRD. A
substantial gap exists between the increase of available information due to techno-
logical progress and the decrease of sensory and cognitive ability due to aging. Our
information technology society demands that people have access to and understand the
dynamic up-to-date contents provided by smartphones, tablets, and digital signage.
The TRD can adapt the interfaces of these informational devices to individual users.
In order to do this, we calculated the relation between the display duration and
recognition accuracy of signs and letters. We then estimated the time required for visual
design recognition. We also introduced some examples of ongoing studies and dis-
cussed the proposed method’s effectiveness.
4.2 Time Reduction Design Experimental Results

As part of our experimental evaluation, we calculated the relation between the display
duration and recognition accuracy of signs and letters, and we estimated the time
required for visual design recognition. The experimental settings and method were
100 J. Ohyama et al.
similar to previous visibility studies. The exception to this concerns the timing control.
We constructed a computer program that can precisely fix stimulus display time to
10 ms per frame (100 Hz). This technique for producing stable high-frequency displays
was previously used in the fields of computer information and gaming but has rarely
been used in experimental psychology and accessibility studies. We applied the time
control technique to the TRD experiments in order to calculate the time required for
visual design recognition.
TRD Studies on Visual Elements. As was previously mentioned, visual signs must
be understood within a short time period. We examined the amount of time required to
recognize visual signs and the ways in which spatio-temporal abilities change with
aging. Table 3 displays the amount of time required to recognize the basic elements of
visual signs.
These studies supported multiple observations. First, the required recognition time
for a 5.62-degree letter was approximately half of that for a 1.69-degree letter. Letter
luminance affected only small letters. Letter color affected letter recognition for letters
with an approximate size of 1.69 degrees but did not affect smaller or larger letters.
Word recognition speed was strongly influenced by its familiarity value but was not
influenced by its ease of utterance. Four-digit numbers required a duration that was
about 1.6 times longer than that needed for three-digit numbers. Pictograms were
recognized faster than road signs, and the simultaneous recognition of three road signs
required 736.2 ms for older persons. If a vehicle were traveling 60 km/h, it would travel
12.2 m in this duration. To recognize three road signs in 50 % of accuracy, older
drivers need to pay attention to the sign during 12.2 m travel. Therefore, our results
imply that demand for the accurate recognition of triple road signs would be difficult
and dangerous for older drivers in most cases.
TRD Study of Caption and Subtitle Design. Movie captions and subtitles are
examples of displays that require a TRD. These texts must have a duration that con-
siders recognition speed. Moreover, captions are useful alternative methods for com-
municating auditory information for deaf and hard of hearing people. Although a
substantial percentage of hearing-impaired people are elderly, the effect of aging on
recognition speed is not addressed during the caption design and creation process.
Figure 3 shows one example from our experimental studies concerning the
required duration of caption presentation. The graph displays the mean required
duration for both young (twenties) and old (60 and older) participants. In the pre-
liminary study, we found that captions containing 25 to 30 letters most frequently
appeared in Japanese National Broadcasting news programs. Therefore, we sampled
captions having 25 to 30 letters from the news to use in the study. Results suggested
that both the threshold and preferred levels of required display time for captions are
approximately twice as long for elderly people than for young people. The average
number of words in each caption was approximately 18 words. Therefore, the mini-
mum duration required for recognition was approximately 44.9 ms per word for young
Table 3. Time required to recognize basic visual elements. Young signifies people in their
twenties, and Elder represents people between the ages of 60 and 80. The estimated durations,
measured in milliseconds, were 50 % and 80 % of the correct duration.
Young Elder
Design for Stimulus conditions 50 % 80 % 50 % 80 %
correct correct correct correct
A letter Size: Color: White 31.44 39.12 38.40 47.49
0.63 Color: Gray 30.79 38.28 51.47 60.41
degree Color: Lime 32.50 38.95
Color: Aqua 33.15 41.07
Color: Yellow 30.80 38.62
Color: Fuchsia 38.05 48.54
Size: Color: White 22.76 32.64 27.13 37.00
1.69 Color: Gray 22.17 31.66 34.95 50.01
degrees Color: Lime 21.89 35.12
Color: Aqua 21.02 33.36
Size: Color: White 5.11 11.14 19.06 30.35
5.62 Color: Gray 6.25 14.20 18.24 33.06
degrees Color: Lime 5.79 10.73
Color: Aqua 4.66 11.06
A word 3 letters Familiar 36.97 96.22
(Size: 1.69 Unfamiliar 40.83 109.35
degrees) 4 letters Easy utterance 36.40 97.39
Difficult 69.05 238.16
utterance
Number 3 digits (Size: 1.69 49.78 105.68
degrees)
4 digits (Size: 1.69 75.37 173.83
degrees)
Sign Pictogram 2.82 20.16
Road One 9.63 31.48
sign Triplet 35.77 736.2
people and 85.2 ms per word for elderly people. These results are consistent with the
TRD studies of visual elements.
We are preparing to propose our guide for the accessible visual presentation of
captions and subtitles to the international standard, ISO/IEC/JTC1.
102 J. Ohyama et al.
Fig. 3. Age-related difference for caption recognition time requirements. The threshold is the
mean minimum duration needed to recognize captions, as determined by the participants. The
preferred level is the mean duration in which caption evaluation is considered easy.
5 Conclusion
In this paper, we discussed multiple aspects of visibility and its age-related changes,
and we demonstrated a method for applying experimental data to the improvement of
everyday designs. We also introduced the long-term accessible visual design research
performed in our laboratory. An interactive database and standard guidelines were
provided as examples. In addition, we introduced the concept of our spatio-temporal
design, the time reduction design, and analyzed experimental results concerning the
time required for visual element recognition. Moreover, our study on caption recog-
nition speed and its relation to aging was presented as an application of our method.
The TRD clarifies the dynamic process of visual recognition for older persons and can
be applied to the estimation and evaluation system of visual designs and user interfaces.
Furthermore, the TRD calculates and evaluates personal abilities of perception and
cognition. Therefore, it can be applied to personalized cognitive assist tools in the near
future.
References
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(2010)
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contrast for coloured light (2010)
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disabilities—Visual signs and displays—Estimation of minimum legible size for a Japanese
single character (2003)
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(1), 24–33 (2013)
5. Sagawa, K., Ujike, H., Sasaki, T.: Legibility of Japanese characters and sentences as a
function of age. In: Proceedings of the IEA 2003, vol. 7, pp. 496–499 (2003)
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db.aist.go.jp/?lng=en
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of older persons and persons with disabilities. Gerontechnology 13(2), 126–127 (2014)
8. Ohyama, J., Itoh, N.: A study of the effect of font color on minimum legible duration of a
character for the time reduction design. In: Proceedings of the 11th Conference of the
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9. Ohyama, J.: Time reduction design: maximize communication efficiency of visual
information by shortest presentation duration. In: Proceedings of 12th Conference of
LS-BT, p. 62 (2013)
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(2005)
A Robot of My Own: Participatory Design of Socially
Assistive Robots for Independently Living Older Adults
Diagnosed with Depression
Selma Šabanović1 ✉ , Wan-Ling Chang1, Casey C. Bennett1,2, Jennifer A. Piatt3,

( )
and David Hakken1

1
School of Informatics and Computing, Indiana University, Bloomington, USA
{selmas,wanlchan,dhakken}@indiana.edu
2
Centerstone Research Institute, Bloomington, USA
3
School of Public Health, Indiana University, Bloomington, USA
[email protected]
Abstract. This paper presents an ongoing project using participatory design

methods to develop design concepts for socially assistive robots (SARs) with
older adults diagnosed with depression and co-occurring physical illness. We
frame SARs development in the context of preventive patient-centered health‐
care, which empowers patients as the primary drivers of health and aims to delay
the onset of disease rather than focusing on treatment. After describing how SARs
can be of benefit in this form of healthcare, we detail our participatory design
study with older adults and therapists aimed at developing preventive SARs
applications for this population. We found therapists and older adults to be willing
and able to participate in assistive robot design, though hands-on participation
was a challenge. Our findings suggest that important areas of concern for older
adults with depression are social interaction and companionship, as well as tech‐
nologies that are easy to use and require minimal intervention.
Keywords: Assistive robotics · Social robots · Participatory design · Elderly ·

Depression · Patient-centered healthcare
1 Introduction
Recent years have seen the proliferation of socially assistive robots (SARs) developed
to improve the functioning and quality-of-life (QOL) of people who experience chronic
and age-related health issues [1, 2]. Much of the research and evaluation related to these
emerging technologies is performed in laboratories and institutionalized care settings
(e.g. nursing homes) and focuses on treatment and rehabilitation. The growing focus on
patient- and community-centered care, however, emphasizes that health is a daily and
lifelong concern, not just an issue that becomes relevant when someone is diagnosed
with a medical condition. Impacting health in daily life – prior to the development of
illness or the need for institutionalized care (i.e. preventative healthcare) – therefore
represents a novel opportunity for exploring applications of assistive robotics. This, in

DOI: 10.1007/978-3-319-20892-3_11
A Robot of My Own: Participatory Design of SAR 105
turn, brings up the need to understand how robots may fit into peoples’ everyday lives
and caregiving communities.
A noteworthy example of a space in which socially assistive robots might be used is
clinical depression in the elderly. Depression is the second leading cause of disability in
the United States [3]; clinical depression affects 15–20 % of older adults in the US [4].
One particular area in which SARs stand to be beneficial is in addressing loneliness, which
is a key component of depression in the elderly and a risk factor for physical/cognitive
decline in this population [5]. Research with SARs in institutionalized settings has shown
that robots can help alleviate feelings of loneliness in older adults [6], suggesting they
could provide therapeutic benefits that reduce symptoms of clinical depression in older
adults living independently as well.
The project presented here explores how SARs could be designed for and used in
the homes of older adults before they become institutionalized, with the aim of
preventing or delaying the need for institutionalization. To address the social and ethical
challenges of developing and deploying assistive robotic technologies in domestic
settings, and in accordance with the paradigm of patient-centered care, we use a partic‐
ipatory design (PD) approach. This method actively involves relevant stakeholders –
older adults with depression, therapists, and case workers – in deciding on the issues
that need to be addressed by research, as well developing ideas for and evaluating new
technologies. The long-term aim of our project is to provide a better understanding of
appropriate designs, deployment methods, and uses of SARs that can lead to more
successful technical and social outcomes. We also explore which PD methodologies are
appropriate for co-designing assistive robots with older adults and staff. We describe
the motivation for our work in more detail below, followed by a description of our
participatory design methodology and initial results from stakeholder interviews and
two participatory workshops held in the Summer and Fall of 2014. We conclude with a
summary of lessons learned so far, and directions for future work.
2 Background and Motivation
2.1 Socially Assistive Robots in Eldercare
Socially assistive robots are expected not only to help people accomplish certain tasks,
but also to have measurable behavioral, cognitive, or therapeutic effects [1]. Researchers
have shown that the therapeutic effects of SARs on the elderly can include positive health
impacts, decreased stress and improved mood, decreased loneliness and better commu‐
nication with others [2]. One projected use for socially assistive robots is to complement
therapists in the course of rehabilitation (e.g. [7]), as well as play both functional and
affective roles in the lives of older adults. Care-O-bot, for example, supports independ‐
ently living older adults by delivering meals and drinks [8]. The seal-like robot PARO
[9, 10] is used as a social companion. Robots can also act as communication devices
between older adults and remote caregivers (e.g. [11]).
SARs development has so far focused on two main contexts of use: the home, where
robots can provide aid to independently living individuals, and institutions such as
nursing homes and hospitals, where robots assist caregivers as well as older adults.
106 S. Šabanović et al.
The development of SARs for these environments raises significant social concerns
beyond the technical issues involved. Field studies of interactions between people and
robots in hospitals (e.g. [12]), nursing homes (e.g. [13, 14]), and private homes (e.g. [15])
have brought attention to the effects of emergent social factors (e.g. workflow, user values
and life histories, the physical environment) on the success and consequences of robots
in healthcare. This suggests that developing SARs for everyday use requires research,
design, and evaluation sensitive to the social context.
2.2 Healthcare-Related Challenges and Opportunities

A patient-centered, long-term view of health emphasizes the importance of preventive
care for improving a person’s quality-of-life over their lifespan [16]. This is particularly
true in chronic illnesses, where a cure is often not available [17]; with issues like
dementia, for example, delaying onset is a key strategy [18]. A preventive approach to
health can also reduce costs and better aligns with patient preferences to minimize time
spent in institutionalized settings [19].
SARs hold significant potential in supporting preventive healthcare, especially
among the elderly. A majority of older adults (70 % of the broader population from
which we draw our participants) have multiple co-occurring chronic health conditions
and/or are at risk of several others. Development of mental illness in older adults (e.g.
clinical depression) often precipitates a significant decline in physical health, which in
turn often leads to the need for institutionalized care [20], and the incidence of co-
occurring disorders only increases with age [21]. SARs can be used to directly intervene
in this cycle, using the abovementioned benefits of SARs to assist users in their homes,
before they become institutionalized.
2.3 Participatory Design and Healthcare
In concordance with patient-centered care and prevention, our approach is also informed
by the use of participatory design methods to develop healthcare solutions. Over forty
years of practice and research in participatory design (PD) for information technology
has shown that negotiation of the social meanings, uses, and effects of technologies by
various groups that stand to be affected throughout the design process can lead to more
successful technical and social outcomes.
Applications of PD methodologies to robotics, though few to date, suggest that active
participation in the design of robotic technologies can empower users with knowledge
about technology, allowing them to take part in critical discussions of the potential social
consequences and meanings of robots [22]. PD has been used to work with community
members to build robotic sensing devices [23]; older adults have also evaluated assistive
robot mock-ups in their homes to explore the potential uses and appearance of assistive
robots [24]. Ezer et al. [25] found that technological experience, rather than age, was
the main predictor of people’s expectations from robots, suggesting that making older
adults more aware of the technical possibilities of robots through PD could increase
acceptance [26]. We can therefore expect stakeholders active in system development to
be invested in and scaffold its deployment and use.
3 Method
3.1 Participants
Our participants were recruited among older adults (>55) experiencing co-occurring
chronic mental (major clinical depression) and physical illness (mainly hypertension,
diabetes, chronic pain, and cardiovascular disease), who receive treatment services from
a large outpatient healthcare provider in rural Indiana, and care staff at the institution.
The providers see over 80,000 distinct patients a year across 150 outpatient clinical sites
in multiple states (e.g. Tennessee, Indiana, Kentucky, and Illinois). The director of one
of the provider’s facilities helped us identify appropriate staff members and older adults
for the study. With their help, we recruited five staff members and five older adults. The
staff members included two therapists, two rehabilitation specialists, and one care coor‐
dinator. The five older adult participants included two women and three men, with ages
ranging from 58 to 71. One of the five older adults was currently employed and all lived
independently on their own.
3.2 Study Procedure
We conducted in-home interviews with individual participants to understand their daily

living context, and then two group workshops to study how participants make sense of
existing SARs, which everyday life issues they find important for their quality of life,
and which design characteristics they desire to be part of future SAR technologies.
Interviews and workshops were transcribed and thematically analyzed by researchers
to describe how older adults thought about and evaluated robots, the challenges they
faced on a daily basis, and how robots might be used to help them.
Interviews. Five staff members were interviewed about their experiences working with
independently living older adults with depression to better understand their practices
and needs. We showed staff videos of existing assistive robotic technologies and asked
them to critique the robots, letting us know whether they thought they would be useful
in their work and what kinds of attributes they thought assistive robotic technologies
should have so they could use them successfully. The videos presented three different
types of robots that were either already available on the market, or under development
for everyday use by older adults in their homes: the seal-like robot PARO1, an assistive
home robot Care-O-Bot2, and the assistive telepresence platform Giraff Plus3. The
videos showed people in nursing homes interacting with PARO in a group activity, while
Care-O-Bot and Giraff Plus were filmed in a user’s home. Care-O-Bot reminded a user
to take her pills, and Giraff Plus was used by a physician to remotely check in on and
examine an older adult at home.
Initial semi-structured interviews were also performed with five older adults in their
homes. We first collected demographic information about participants, and then asked
1
https://www.youtube.com/watch?v=3npV-npZkxI.
2
https://www.youtube.com/watch?v=3tTKiVuyem4 (showed approximately first 3 min).
3
https://www.youtube.com/watch?v=Pjgf3Yi81ao.
them to tell us about their current life situation and experiences, the social relationships
they were involved in (e.g. partners, family, friends), specific issues they faced in their
daily lives (e.g. mental and physical health, social interaction), and the types and uses
of technology in their daily life. The interviews ended with a walk-through of the partic‐
ipant’s house, documented through field notes and photos.
Participatory Design Workshops. We held two participatory design workshops with

older adults to give them opportunities to more actively contribute to the development
of SARs.
The first workshop lasted approximately two hours. Four participants (3 male and 1
female) and four researchers were in attendance. One participant could not attend due
to health reasons. For the first hour, participants watched and critiqued the same videos
showing assistive robotic technologies that the therapists saw (PARO, Care-O-Bot,
Giraff Plus), with one additional robot (Papero4). The Papero robot was added as an
example of a robot used for multimedia communication and social interaction, since the
initial interview suggested these topics were of particular interest to participants. Papero
was described in the video as a robot that could recognize individual participants and
help them use email and communicate with others. In the second hour, participants saw
live demonstrations of robots, including the robotic seal PARO, MugBot, Keepon, and
Roomba (see Fig. 1). The live demonstrations consisted of researchers giving a brief
description of each robot’s functions (e.g. “Roomba can vacuum the floor by itself”;
“Keepon can dance to music”) as the robot performed them (e.g. PARO moved and
made seal-like sounds, Keepon danced, and we showed how to program Mugbot using
a simple Scratch-based interface). During the demo, participants could touch and explore
the robots as they liked. Our main aim for this workshop, and the focus of questions to
participants, was to learn what participants think of existing technologies, how they
relate these technologies to their experiences and concerns, whether they can see them‐
selves using such technologies, and what they would want such technologies to do for
them in the future. We also noted successes and challenges in getting participants to
actively participate in the workshop to help us further develop PD methodologies for
older adults.
Fig. 1. Participants experienced live demos of PARO, the Roomba, MugBot (a programmable
social robot), and Keepon, during which they could freely interact with the robots.
4
https://www.youtube.com/watch?v=s7MqCNgFAzY.
The second workshop lasted approximately 3 h. Three participants (1 female and 2

male) and five researchers were in attendance. This time two participants could not
attend due to health reasons. The aim of the workshop was for researchers to work
together with participants to design assistive robots that could fit into their daily lives.
We started the workshop by asking participants to tell us about specific challenges they
faced the last time they were feeling sad or lonely. We also explored PD methods to
help participants engage in creative thinking regarding assistive technologies.
Researchers assisted participants in materializing their visions of robots by sketching
them out during the workshop. We ended the workshop with a general discussion of the
potential uses of assistive technologies, how they can be used to address issues related
to aging and depression, and comments on the workshops themselves.
4 Findings
4.1 Interviews
Staff members showed a lively interest in integrating more digital technologies,

including robots, into their therapeutic practice. After viewing videos of four different
assistive robots, the staff was unanimous in choosing PARO as the one they would be
most likely to use with their clients. They particularly commented that the robot was
low maintenance, and could provide companionship for the older adults they worked
with– something they can care for like a pet, without overwhelming them. The interviews
with older adults, carried out in their homes, showed this population is interested and
able to take part in participatory research related to SARs. In the course of the interviews,
one of the main challenges older adults emphasized was loneliness, along with physical
health problems. They all mentioned social interaction with friends, family members,
and pets as a factor that can make them feel better when they are depressed. Two of the
five older adults had pets, but both mentioned they may not be able to take care of them
for much longer due to their condition. All the participants used computers and cell‐
phones, but only two used it regularly for email and online purchasing, and only one
enjoyed using the computer. These interviews also provided researchers with a sense of
participants’ home arrangements, which included one house, three apartments, and a
trailer home.
4.2 Workshop 1
Four older adults participated in the first workshop, led by the first author. In contrast
to expectations that older adults might be wary of robots, the participants had no hesi‐
tation about discussing them and considering their usability at home. All participants
described several ways they might use the robots and commented which devices they
would like to buy, defining themselves as potential consumers of robots.
The most positive responses were to PARO, both after watching the video and while
interacting with the robot. One participant, who had previously worked in a nursing
home, was impressed at the level of interactivity older adults in the video showed toward
the robot. Participants liked that PARO was easy to take care of and did not require
cleanup. One participant remarked that the robot’s presence created a “happy attitude
about life” in users. The only downside to PARO that participants mentioned when
prompted was that it was “not alive”. When asked where they might use PARO, partic‐
ipants mentioned it could be helpful after surgery or at home, particularly during
“gloomy days.”
Participants were also positive about the Giraff Plus telepresence robot they viewed.
They liked the idea of having someone track their activities, and the ability to commu‐
nicate with medical staff, family and friends in a more physically embodied way. Partic‐
ipants liked the idea of having a robot present in case of a fall, mentioning that it could
notice the problem more quickly than they could call for help, and be able to assist them
and keep them company while they wait for humans to arrive. They commented on the
robot’s ease of use. One additional design request was for portability, so they could take
the robot outside while doing yard work or walking.
The Care-O-Bot, a mobile domestic robot, was seen as good for reminding partici‐
pants about their medications (a function shown in the video), and possibly warning
them against eating too many sweets or doing other unhealthy things (ideas from partic‐
ipants). Participants commented positively on the robot’s ability to support communi‐
cation and staying in touch with loved ones. They described the early version of the
Care-O-Bot shown as not aesthetically pleasing, too big to fit in their homes, and not
appropriate for children and pets, who might harm or get hurt by the robot.
NEC’s communication robot Papero also inspired many positive comments. Partic‐
ipants found it easy to use and fun, and appreciated its communication and social
capabilities, particularly the ability to recognize people and adjust to their needs for
personalized interaction. One participant also mentioned that Papero might be able to
help him get out of his gloomy moods by talking to him and keeping him company.
In addition to responses to robot videos, the robot demonstrations allowed us to see
how participants might actually interact with robots. As mentioned above, participants
started interacting with PARO as soon as it was brought out and did not hesitate to touch
and talk to it. They also easily approached Keepon, which they anthropomorphized
readily (one participant said the robot “didn’t like him,” another mentioned it was
“checking everyone out”). One participant mentioned Keepon would be good for their
grandkids to play with when they visited, another said it might inspire him to get up and
dance. Participants liked the appearance of MugBot, a minimalist social robot, but were
quite negative about the possibility of developing programs for the robot with the
Scratch-based5 interface we showed them. They commented that working with the
computer seemed difficult, and one participant mentioned that he preferred not to be on
the computer, though he had one at home. Two out of four participants said they would
like to use the Roomba, and one chose it as the robot they would most like to have in
their house.
Overall, the ability to support companionship and sociability, whether with the robot
itself or with others through telepresence, emerged as the most compelling use of SARs
for this group. The unanimous interest in PARO seemed due to the possibility of having
a close, tactile interaction with it. One participant described it as “inviting… almost like
5
http://wiki.scratch.mit.edu/wiki/Scratch_User_Interface.
a real animal that can relate to you.” Another said he found it “comforting” and “moti‐
vating” to be more active. Papero was appreciated for its ability to recognize individual
users and its communication skills. In contrast, the most machine-like robot seen on
video, and the programmable robot we demonstrated, were quickly dismissed as unat‐
tractive, difficult to use, and not fitting into the home.
4.3 Workshop 2
The negative responses participants gave to the mechanical appearance of the Care-O-
Bot and the idea of programming MugBot suggested they were not ready for hands-on
work with robots, so we decided to design and critique robots with them by visualizing
their ideas on paper. We first prompted participants to tell us about the day-to-day chal‐
lenges they face in their homes, then reminded them of the various capabilities robots
have to provide social and physical assistance, and finally asked them which functions
and capabilities they would want robots to have to help them with the daily issues they
had identified. In order to make the process iterative, two researchers produced drawings
of the robots as participants described their appearance, capabilities, and uses. The three
participants then critiqued the drawings, pointing out things they liked or did not like,
and leading to further iterations of their desired robot designs.
When asked to remember a time when they were feeling sad or lonely in the last
month, and to tell us something they would have liked help with during those times, one
participant mentioned physical challenges: difficulties in lifting things around the house
and cleaning. Another pointed to his anger issues, and the desire to have some help in
curbing them. A third participant mentioned that his big challenge were the upcoming
Thanksgiving and Christmas holidays, with which the other two then agreed. The partic‐
ipants went on to discuss not being able to spend the holidays with family, friends and
loved ones for various reasons. They also mentioned not having money, or the health
for holiday preparations. Most of all, participants discussed wanting someone to talk to
and spend the holidays with, even pets. Two participants mentioned they had been able
to work as volunteers before their illness; they now missed the feeling of helping others
and being useful. All participants described the lack of companionship as a trigger for
their depression, mentioning that days when they do not have doctor visits of other
activities planned (such as the weekend) were the most difficult, “the longest days.”
After discussing their everyday challenges, participants and researchers collaborated
to design robots that might be able to help them. The first suggestions from participants
were to make a talking version of the robotic seal PARO, which might say “Good
morning to you” or “It is now time for this [activity],” or that it could be used as a
medicine or event reminder. Participants then said that what they really want is a some‐
thing or someone that will keep them company, read and discuss the news and television
shows with them, play games and eat with them. The participant who had mentioned
anger issues pointed out that such a robot could help him deal with his anger by asking
him to “Get your act together.” Another participant said the robot could know the
weather and tell her how to dress, and help her control her diet.
To realize these ideas about robots, two researchers drew up their interpretations of
the participants’ ideas as the conversation proceeded. The first suggested embodiment
was a robotic coffee pot (See Fig. 2), which participants unanimously evaluated as not
being humanlike enough. One participant mentioned that he would like his robot to be
like the singer Mariah Carey, more humanlike in size and appearance. The need for
portability, and wanting to take the robot along on walks, to the park, to the doctor’s
office, was brought up. Finally, participants agreed that the robot would have to be low
maintenance, not something they would need to fix or attend to in any way.
Fig. 2. Workshop 2 produced designs for robotic appliances, small robotic assistants, and
humanlike robots that could provide a companionship role for participants.
As in the prior workshop, the need for companionship and social interaction was
discussed at length and became a focal point of participants’ designs. Along with social
interaction, however, participants also pointed out a variety of health-related functions
that robots could perform, including providing reminders and suggesting appropriate
things to eat, wear and do during the day. The use of visualizations during the second
workshop allowed participants to critique and develop more specific ideas of robots that
would be appropriate for their daily lives. In future work, we are interested in inspiring
more in-depth discussions of specific interaction scenarios between robots and people,
so that we can further hone our understanding of participant needs and perceptions of
domestic SARs designs.
5 Conclusion
Socially assistive robots are a promising technology for preventive, patient-centered care.
The ongoing project described here uses participatory design to explore appropriate ways
of implementing SARs to aid older adults with co-occurring depression and chronic phys‐
ical illness in order to delay the need for institutionalized care. The participatory design
activities we performed provided us with concrete evidence of interest and support from
both staff and older adults for the introduction of SARs technologies into their therapeutic
services. These experiences also demonstrated that there is clearly a place to explore the
therapeutic value of these technologies in the home and gave us confidence, based upon
our developed understanding of these specific home environments, that it will be possible
to integrate them into therapeutic practice and the daily life of their clients. We identified
companionship as a central unmet need in the lives of our older adult population, and
started discussing with them how this need might be met through the application of robotic
technology. Finally, we showed that older adults are willing and able to participate in
design projects for SARs (admittedly their participation is partially motivated by the desire
to get social interaction), and identified the need for developing methods for actively
engaging older adults in SARs design. Our future work will focus on further under‐
standing how older adults might interact with SARs in their homes, and on increasing the
level of hands-on participation of our participants and their self-identification not only as
consumers, but as creators of assistive robotic technologies.
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Universal Design as an Approach
to Technology Intervention for Seniors
Jon A. Sanford(&)
Center for Assistive Technology and Environmental Access, Georgia Institute

of Technology, Atlanta, GA, USA
[email protected]
Abstract. Typical design approaches for technology interventions for seniors

tends to focus on specialized design to accommodate functional limitations
associated with either disability or aging. This paper will propose universal
design as an alternative approach that focuses on design for all users, regardless
of age or ability. Moreover, while specialized design is based on prescriptive
requirements that often dictate what to design, universal design is an approach to
technology intervention that is guided by a set of performance principles and
guidelines that provide a rationale for how to design technologies. As such,
universal design as extends the usability of everyday design to seniors, without
the need for special adaptations or devices.
Keywords: Universal design Design for aging Specialized design Tech-

nology for seniors
1 Introduction
Much has been written about the design of assistive and other types of technology
interventions as a rehabilitation strategy to facilitate health, activity and participation of
individuals with a variety of impairments and disabilities. Similarly, much has been
written about the design of technology interventions as a strategy to promote aging in
place by seniors undergoing the normal aging process. However, little consideration
has been given to universal design as an approach for technology intervention for
seniors who are experiencing both disability and age-related declines in function. The
reason is simple, universal design is typically viewed as incompatible with the fun-
damental goals of rehabilitation and design for aging technologies (Nichols et al. 2006).
Whereas these approaches are specialized designs tailored to needs of individuals or
groups of individuals with either impairments or age-related deficits, or both, universal
design is not intended specifically for older adults or those with impaired function.
Rather, it is design that is usable by all people to the greatest extent possible without the
need for adaptation or specialized design (Mace et al. 1991). As Steinfeld (1994)
pointed out, these differences are not simply semantic. Specialized design typically
results in separate designs for people with functional limitations, while universal design
provides one design solution that can accommodate people with disabilities and lim-
itations as well as everyone else.

DOI: 10.1007/978-3-319-20892-3_12
116 J.A. Sanford
Although universal design may be conceptually appealing, this paper recognizes

that it is a utopian design philosophy that is not technically achievable in the design of
hardware, which has a fixed form, although more likely achievable with software,
which has a more fluid form. Nonetheless, universal design imagines what a world
should be, not necessarily what the world will be. As a result, the contribution of this
paper is in providing technology designers with a new way of thinking about inter-
ventions for seniors.
2 Types of Interventions
Technology can be, at the same time, prosthetic and therapeutic, compensating for
limitations in functional abilities and enabling health maintenance and management. As
a prosthetic, technology interventions for seniors can facilitate basic activities associ-
ated with safe and independent living, participation in social roles and provision of
personal assistance from caregivers as needed. Therapeutically, it can facilitate health
promoting behaviors and provision of healthcare services.
2.1 Specialized Technology as a Prosthetic Intervention

To remove or overcome barriers to performance of routine tasks and activities by
people with disabilities and age-related limitations specialized “accessibility” tech-
nologies have traditionally been added to (e.g., voice over and high contrast screens) or
replaced (e.g., devices with large simplified, large font keypads or augmentative
communication devices) everyday designs. Acting as facilitators that address barriers
created by the design of everyday technologies, specialized designs serve as prosthetic
supports that facilitate the performance of everyday activities by compensating for
disability and other limitations in ability. With the assistance of specialized designs
individuals with a variety of limitations are able to carry out basic activities associated
with daily living safely and independently and receive personal assistance from care-
givers that would otherwise not be possible.
Nonetheless, specialized technologies are solely intended to enhance the perfor-
mance of individuals with functional limitations, not of the general population (Sanford
2012). They are, by nature, reactive approaches that are added on to everyday designs
or are specialized designs only for those who need it. Thus, despite their role in
enabling activity by people with functional limitations, they are often associated with
the stigma of disability, and as such are not used by seniors who do not see themselves
as being “disabled.”
However, people are growing older and a larger number of individuals are living
longer with disabilities. Not surprisingly, a considerable amount of research over the
past three decades has shown that the traditional specialized design approach does not
adequately compensate for the range of age-related comorbidities and secondary
conditions, including limitations in strength, stamina, reach, dexterity and fine motor
control, lifting legs and sit-to-stand, loss of contrast sensitivity and visual acuity,
memory loss and diminished cognitive functioning, and hearing loss that are common
Universal Design as an Approach to Technology Intervention for Seniors 117
among seniors. As a result, specialized design, which is intended to promote acces-

sibility, neither ensures usability, but may do more to promote excess disability among
older people than to ameliorate it (Sanford et al. 1999; Sanford and Megrew 1995).
Similarly, specialized design, which is intended to promote independent functioning,
may not be adequate for seniors who are often dependent in one or more basic activities
of daily living; or for their spousal (i.e., also aging) caregivers, for whom accessible
design is not intended. These suggest that a more universal approach based on the
needs and capabilities of a wider range of individuals is warranted.
2.2 Health Technology as a Therapeutic Intervention

By 2015 an estimated 150 million Americans will have at least one chronic condition
due to a variety of causes such as congestive heart failure, cardio pulmonary diseases,
deterioration in musculoskeletal system and connective tissue, and injury (Wu and
Green 2000). With the increase in chronic health conditions there has been a dramatic
increase in the level of care requirements including the need to engage teams of
multiple physicians, specialists and formal and informal caregivers. As a result, chronic
diseases account for 75 % of all U.S. healthcare costs (Scheschareg 2005).
As the intensity and cost of chronic care has increased, the use of personal health
technologies, particularly in the home environment has played an ever-expanding role
in health management and prevention. With the dramatic increase in home care services
provided by Medicare in the past two decades, the boundary between hospital and
home has become blurred (Binstock and Cluff 2000). This growth has not only been
fueled by a desire for reduced lengths of stay and controlling cost, but also by a variety
of new home-based therapeutic products and technologies that support aging in place
through more active care management and passive monitoring of safety and activity.
By placing a greater emphasis on prevention and wellness than on acute care,
home-based technologies are changing the way health care is provided to seniros and
the way in which the home environment is utilized and conceptualized. Such tech-
nologies enable family members and health care providers to manage and promote
health by: (1) actively monitoring health status (e.g., vital signs, weight, and oxygen
saturation) that requires engagement of individuals to manage own their care; (2) pas-
sively monitoring activity (e.g., bathing, toileting, eating, medication adherence, and
physical movement), and potential safety hazards (e.g., turn off stove burners, maintain
water temperature to prevent scalding, adjust lighting levels to prevent falls risks, detect
smoke and lock doors to prevent wandering of individuals with dementia) through
sensors, transmitters, and receivers embedded in the environment (e.g., woven into
carpet); and (3) promoting interactive communication with social networks and clini-
cians via cell phones, videophones, internet, television, camcorders, and communica-
tions software to enhance both psychological and physical health.
Like specialized designs, medical devices and technologies can have a large impact
on the home environment and on the individuals living there. Many healthcare devices
and technologies were developed for institutional settings, which are very different in
size and appearance than residential settings. Moreover, they these devices and tech-
nologies were designed to be used by trained healthcare professionals not lay
118 J.A. Sanford
consumers. As a result, technologies often exceed the skills and abilities of seniors. Of
equal importance in residential environments is aesthetics. Devices that look institu-
tional are neither compatible with residential settings, nor do they consider the personal
needs and tastes of the residents. This not only creates stigma, but leads to disuse and
abandonment.
3 Universal Design as a Technology Intervention Strategy
Conceptually, universal design does not view disability as a single point requiring
specialized technology intervention, but a segment of the continuum of ability that
benefits from usability and inclusivity to promote positive activity and participation
outcomes, respectively (Sanford 2012). Rather than focus on limitations in ability, the
appropriate focus of universal design is on the range of human performance charac-
teristics that are shared by all and experienced across our lifespans. Thus, universal
design not only facilitates performance for an individual at any point in time, but also at
any point across an individual’s lifespan.
Universal design of technology for seniors is radically different from specialized
technology design both conceptually and in physical form. Conceptually, specialized
design is an add-on component or special “senior” design to remove the barriers created
by the misfit between everyday design and seniors with functional limitations. In
contrast, universal design is an integral component of everyday design that addresses
barriers from the very beginning of the design process. As such, universal design
supports the broadest range of types and levels of all abilities for all individuals,
regardless of age, stature or physical function. These qualities are captured by and
articulated in the Principles of Universal Design (Connell and Sanford 1997).
4 The Principles of Universal Design
With support from the National Institute on Disability and Rehabilitation Research, ten
leading proponents of universal design, including architects; industrial, landscape, and
graphic designers; and engineers developed the 7 Principles of Universal Design
(Table 1) to define the general performance goals and guidelines for universal design.
Although the Principles have never been validated and are too generic to apply as
design criteria, in less than a decade they had been translated into a number of different
languages and reprinted on hundreds of websites around the globe. Despite their
shortcomings, the Principles are useful for guiding and evaluating the usability and
inclusivity of technology interventions for seniors.
4.1 Equitable Use

Design of technology should be equally usable by and marketable to everyone. It
should avoid segregating and stigmatizing users, and it should provide the same means
of use for everyone. When possible means of use should be identical (e.g., the same
Table 1. Principles of Universal Design (Connell 1997)
Principle 1. Equitable Use: The design is useful and marketable to people with diverse abili-
ties.
1a. Provide the same means of use for all users: identical whenever possible, equivalent when
not.
1b. Avoid segregating or stigmatizing any users.
1c. Provisions for privacy, security, and safety should be equally available to all users.
1d. Make the design appealing to all users.
Principle Two: Flexibility in Use: The design accommodates a wide range of individual pref-
erences and abilities.
2a. Provide choice in methods of use.
2b. Accommodate right- or left-handed access and use.
2c. Facilitate the user's accuracy and precision.
2d. Provide adaptability to the user's pace.
Principle Three: Simple and Intuitive Use: Use of the design is easy to understand, regardless
of the user's experience, knowledge, language skills, or current concentration level.
3a. Eliminate unnecessary complexity.
3b. Be consistent with user expectations and intuition.
3c. Accommodate a wide range of literacy and language skills.
3d. Arrange information consistent with its importance.
3e. Provide effective prompting and feedback during and after task completion.
Principle Four: Perceptible Information: The design communicates necessary information
effectively to the user, regardless of ambient conditions or the user's sensory abilities.
4a. Use different modes (pictorial, verbal, tactile) for redundant presentation of essential infor-
mation.
4b. Provide adequate contrast between essential information and its surroundings.
4c. Maximize "legibility" of essential information.
4d. Differentiate elements in ways that can be described (i.e., make it easy to give instructions
or directions).
4e. Provide compatibility with a variety of techniques or devices used by people with sensory
limitations.
Principle Five: Tolerance for Error: The design minimizes hazards and the adverse conse-
quences of accidental or unintended actions.
5a. Arrange elements to minimize hazards and errors: most used elements, most accessible;
hazardous elements eliminated, isolated, or shielded.
5b. Provide warnings of hazards and errors.
5c. Provide fail-safe features.
5d. Discourage unconscious action in tasks that require vigilance.
Principle Six: Low Physical Effort: The design can be used efficiently and comfortably and
with a minimum of fatigue.
6a. Allow user to maintain a neutral body position.
6b. Use reasonable operating forces.
6c. Minimize repetitive actions.
6d. Minimize sustained physical effort.
Principle Seven: Size and Space for Approach and Use: Appropriate size and space is pro-
vided for approach, reach, manipulation, and use regardless of user's body size, posture, or
mobility.
7a. Provide a clear line of sight to important elements for any seated or standing user.
7b. Make reach to all components comfortable for any seated or standing user.
7c. Accommodate variations in hand and grip size.
7d. Provide adequate space for the use of assistive devices or personal assistance.
120 J.A. Sanford
hardware and software), when not possible, equivalent means should be available (e.g.
the same hardware, with different or customizable interfaces). Universal design features
should be integrative and inclusive. In this way, universal design is everyday design,
appealing to everyone, not just people who need special design features.
4.2 Flexibility in Use

Technology design should accommodate a wide range of individual preferences and
abilities. It should also be forgiving, providing choices in methods of use. At the scale
of interface control, use of multimodal input/output (I/Os) (e.g., touch, voice, physical
buttons) and navigation (e.g., touch buttons, scroll, and swipe gestures) methods enable
an individual to choose according to need and ability. Similarly, interfaces should also
be tolerant and forgiving of different abilities by adapting to a user’s levels of precision,
accuracy and pace, such as physical inputs that minimize exactitude (e.g., large touch
buttons separated by sufficient space), visual information that requires little acuity (e.g.,
large text size, high color contrast) and audio information that has variable speed and
volume. At the level of flexibility of interfaces, software enables the design of multiple
or customizable interfaces with choices of I/Os to be used with the same hardware.
4.3 Simple and Intuitive Use

Regardless of the user’s experience, knowledge, language skills, or level of concen-
tration, interfaces should be easily understood. In addition, the information should be
intuitive, obvious and spontaneous, even if an individual has never encountered that
design before (e.g., yes/no responses, widely recognized icons for text size, audio
speed, contrast, up and down arrows). To accomplish this, interfaces should eliminate
unnecessary complexity (e.g., multiple screens or dropdown menus to control visual
clutter), present information in a manner that is consistent throughout the application
(e.g., the same input controls in the same place on each screen) and with its importance
(e.g., on/off button on top) and provide prompting (e.g., visual and verbal queries) and
feedback (e.g., auditory response or visual acknowledgement) to respond to inputs.
4.4 Perceptible Information

To effectively communicate information to users who have different abilities to see,
hear and understand, interface design should use as many different modes (e.g., pic-
torial, text, verbal, tactile) as possible. Devices should integrate simultaneous visual
and audio output as a default, rather than using separate outputs that require that the
audio be turned on. In addition, touch screen buttons should provide redundant visual
cues through color, icons, and text.
Regardless of the mode used, design should maximize “legibility” of the essential
information by providing large/adjustable font sizes, adequate (e.g., visual, auditory,
cognitive) contrast between the essential information and the background, differenti-
ating elements in ways that can be described (i.e., make it easy to give instructions or
directions, such as “push the red button first”) and enabling users to use any assistive
devices, such as low vision or hearing aids, that they might require to obtain infor-
mation. Finally, tactile information should be integrated into the hardware to help
locate inputs on non-tactile digital interfaces.
4.5 Tolerance for Error

Errors can result in both a risk to personal safety (e.g., communicating wrong medical
information or not pushing the right button in an emergency) as well as inadvertent
mistakes that can lead to loss of time and frustration (e.g., hitting the delete button). As
a result, technology design should minimize hazards and unintended actions that could
have adverse outcomes. To do so, unconscious actions in tasks that require undivided
attention (e.g., communicating medical information) should be discouraged by using of
fail-safe features, such as locating contradictory input buttons (e.g., yes/no,
accept/delete) far apart; providing warnings and verification queries to confirm a
selection or identify mistakes; and arranging elements so that those that are most
important are most accessible and those that are least important are omitted or protected
(e.g., menus and help buttons) at the top and forward/back buttons at the bottom.
Finally, page sub-review and final review options should be provided to ensure that all
inputs are as intended.
4.6 Low Physical Effort

Ease of use is perhaps the one quality that is most commonly associated with usability.
However, Principle 6 goes beyond simple ease/difficulty to include performing tasks
efficiently, comfortably and with minimal fatigue. To accomplish these outcomes, the
design should locate the primary input buttons and use gestures that will enable the user
to maintain a neutral body position; minimize strength and stamina by enabling use of
low (or no) operating forces, such as using digital touch vs. physical buttons; mini-
mizing the need to apply sustained force (e.g., voice input); and minimizing repetitive
and simultaneous actions without resting, such using a single tap vs. a double tap.
4.7 Size and Space for Approach and Use

Size and space for interface design includes the visibility (both visual and tactile),
location and size of targets on the screen to permit use by individuals with a range of
visual and dexterity abilities. For example, placing large buttons in the corners or the
edges of the screen enhance visibility for blind or visually-impaired users. In addition,
large targets can enable components to be reached comfortably by users with limited
reach or dexterity.
122 J.A. Sanford
5 Discussion
Adopting universal design as a viable technology intervention strategy for seniors

requires discarding current, yet outdated 20th Century paradigms that favor specialized
interventions for identified groups over those that promote functionality for everyone.
Despite the technical success of traditional specialized technology intervention strat-
egies in increasing function for individuals, they have, on the one hand, promulgated
the proposition that being able to perform an activity would enable seniors to suc-
cessfully age in the community, while creating stigmatizing and segregating devices,
on the other. In contrast, universal design is rooted in a more integrative paradigm that
makes function and functionality (i.e., usability and inclusivity) the design norm rather
than the exception. By integrating specialized design into everyday technology, uni-
versal design is not just hard to see, it is invisible.
This idea of intervention invisibility is clearly not an outcome with which reha-
bilitation and design for aging practices are familiar. It clearly requires a paradigm shift
from one that is emboldened by a set of prescriptive rules of what to do to a set of
performance guidelines (i.e., Principles of Universal Design) that define why it should
be done.
References
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Connell, B.R., Sanford, J.A.: Research implications of universal design. In: Steinfeld, E.,
Danford, S. (eds.) Measuring Enabling Environments, pp. 35–57. Springer, New York (1999)
Mace, R., Hardie, G., Place, J.: Accessible environments: toward universal design. In: Steinfeld,
E., Danford, S. (eds.) Innovation by Design, pp. 155–175. Van Nostrand Reinhold Publishers,
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Nichols, T.A., Rogers, W.A., Fisk, A.D.: Design for aging. In: Salvendy, G. (ed.) Handbook of
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A Living Lab Method for Innovations to Increase
Quality of Life for Elderly - A Pilot Case
Isabella Scandurra1(&), Madeleine Blusi2, and Rolf Dalin2

1
School of Business, Department of Informatics, Örebro University, Örebro,
Sweden
[email protected]
2
R&D Department, The Association of Local Authorities in Västernorrland
County, Härnösand, Sweden
{madeleine.blusi,rolf.dalin}@kfvn.se
Abstract. A Swedish Living Lab has recently been established offering care
organizations a test and evaluation method as an activity in their intrinsic
development process. Using the method, innovations for an aging population are
assessed, guided by quality criteria as well-being, dignity, value for the elderly
and usability.
This paper describes the method through a pilot test, carried out in November
2014 by the elderly themselves and health and social care staff at a nursing home
together with different academic parts in a multidisciplinary test process. The
method allows for interaction between innovators and stakeholders as well as
potential end-users in the elderly care sector. Simultaneously, the users’ quality
aspects are kept in focus when innovations for the aging society are tested.
Keywords: Aging society Elderly care Innovation Living lab Usability

User participation Health/welfare development Test Evaluation
User-centricity
1 Introduction
Many countries with ageing populations need to work on how to incorporate inno-
vations of different forms into the ongoing process of change in social service, support
and care of the elderly. Future care provision for the elderly is facing multiple chal-
lenges. There is an ongoing change in demographic structure, where proportions as
well as numbers of older people with care needs are rapidly increasing, bringing an
increased demand for long-term care services [1, 2]. Current supply is considered as
insufficient and inadequate in terms of meeting future needs for long-term care [1]. Yet
another challenge is difficulties recruiting new work force to health professions [3]. In
Sweden the prognosis is a deficit of 100 000 healthcare professionals by 2030 [4].
Including technology in long term care of elderly is an opportunity not only to increase
quality of care, but also to maintain care in the future [5]. Some established examples
are Internet-based support services that can contribute to elderly people living in their
own homes to live their lives with higher levels of independence and electronic devices

DOI: 10.1007/978-3-319-20892-3_13
124 I. Scandurra et al.
that increase social inclusion of elderly [6–8]. Another technology useful in care of the
elderly, at home or in nursing homes, is sensor technology. Sensor technology retrieves
essential information about the individual which can be used by e.g. nursing staff to
supplement their own observations, thereby helping them to better understand and tend
to the needs of the elderly person [9]. The pilot case that exemplifies the method in this
paper tested an innovation based on sensor technology.
A Test Arena Initiative. In society there is an ongoing trend to bring in new methods,
systems or tools to aid the renewal of life situations and work processes as well as to
realize the usage and dissemination of those new ideas, methods and techniques. In
Sweden, a national initiative to innovate elderly care is taken based on the firm belief
that test and demonstration arenas can help companies and organizations to increase
their competitiveness, efficiency and quality [10].
Test and demonstration arenas are promising as they create new knowledge that
cannot be captured using simulations or small-scale experiments; new partnerships can
be developed and complex tests that an individual actor could have difficulties to afford
can be realized by cost-sharing and joint learning and developing. The assembly and
management of a realistic test arena both related to e.g. technology and real-life
observations is costly and therefore impossible for small innovative companies to carry
out, especially when testing their first product. To enable relevant and qualitative
testing, it is of outmost importance that test facilities are available and functions on a
per usage cost [11]. Further, it is sometimes crucial to create an understanding and
visibility of potential social benefits thanks to technical innovations in order to develop
and spread certain products and services.
Test arenas can move from the very delimited to the extremely wide, from an area
which actually has a different main objective, such as a neighborhood, to specifics and
details like lab tests of research equipment. A mapping study performed by the Swedish
Innovation Agency VINNOVA showed a great mix of research and innovation
infrastructure with many different denominations, e.g. test bed, living lab, prototype
workshops, pre-incubator and pilot plants to name a few [10].
Moreover, innovations or new ideas may arrive from different actors; e.g. from
well-experienced care personnel, from research, as well as from technical innovators.
An important matter is that the innovations need to be tested in real-life situations
before implemented in elderly care practice, to date an activity hard to achieve.
Norrlandicus is an open innovation and test environment formed as a Living Lab,
established in 2013 in Sweden. In Norrlandicus actors aiming to develop health and
social care for elderly through innovation, are offered a test and evaluation method as
an activity in their intrinsic development process. The method intends to suit tests of
not only products, but also services and processes. The objective of the test method is
to show whether the innovation adds increased value in a health and social care process
for the elderly, and to measure to what extent the innovation is perceived useful by the
end-users.
The purpose of this paper is to present the novel test method that is the basis for the
test process used in the Living Lab Norrlandicus. The method is exemplified by a pilot
case that tested an innovation for an aging population by guidance of quality criteria as
well-being, dignity, value for the elderly and usability of the innovation.
A Living Lab Method for Innovations to Increase Quality of Life 125
The Norrlandicus Living Lab. As a Living Lab, Norrlandicus consists of a number

of test persons in a number of test arenas. A test arena can for example be a nursing
home, a sheltered housing or the private homes of older persons living in their own
houses. For each innovation to test a specific living lab is created, where the purpose
and goal criteria of the innovation are mapped to a suitable setting in the municipality
elderly care, i.e. an ad hoc-setting. In the living labs, innovations are tested based on a
triangular approach [12] where the elderly, their next of kin and health- and social care
staff are not only involved, but are the real test persons and drivers of the test of the
innovation. As an aid in the assessment, experts from academia and industry with many
years of experience in evaluating usability, health and social care quality, innovation,
business models, functionality and health economics are provided within Norrlandicus
[13]. Norrlandicus is an ongoing research and development project, partly financed by
The Swedish Agency of Innovation Systems, VINNOVA, and the County Adminis-
trative Board in Västernorrland. Norrlandicus is owned by a partnership constellation
that works to create an environment where industry, academia and expertise in health
and social care can meet to develop innovations for future care.
2 Method and Materials
Each innovation in Norrlandicus is assessed via quality measures from the users’
perspectives and for validation purposes. Validation in this context means to examine
to which extent the innovation contributes with intended effects to a health and social
care process for elderly. The foundation of the novel test method is described along
with an example providing more detailed information from a pilot case that tested an
innovative tool for investigation of urine incontinence.
Norrlandicus Test Method. Innovations are tested in Living Labs. For each test an ad
hoc environment is selected in an appropriate care facility within the elderly care
sector, e.g. a nursing home or a home care district. The authors of the test method work
on-site in a multidisciplinary team, with expertise from the domains of caring science,
statistics, health informatics and human-computer interaction. The test method as such
builds on the “National Values for Social Care of Elderly”, here translated as “Dignity
of Life” [14]. Addressing basic health and functional needs is important; a salutogenic
approach to health, considering participation and independence, promoting good health
and rehabilitation [15], has been a core value in developing the test method. Along with
salutogenic values the test method strives to enlighten dignity and well-being as
dimensions of Dignity of Life. There is a lack of evaluations following such quality
measures in the care sector in general, and a method that measures dignity of life
related to innovations in elderly care was until now completely absent. Therefore, this
test method is unique as it is based on concepts from Dignity of Life and relates those
to a (technical) innovation in elderly care. The evaluation is further guided by a third
dimension, quality criteria of the international usability standard, highlighting the usage
as a function of the innovation and its defined end-users [16], (Fig. 1).
Fig. 1. Three dimensions of the test method with the core value Dignity of Life
Based on the concepts of values a few factors were derived, for which the research
team developed a number of issues (sets of “items”) with scales for the factors. On a
policy level, the questions are general. On the level of details, tests are based on the
purpose and potential usability of the specific innovation in its real context, according
to the international usability standard [16].
The target audience is older people (65+) with age-related needs. Innovations will
affect the elderly, either directly or indirectly. The Norrlandicus method investigates
whether the introduction of an innovation in older people’s immediate environment or
nursing situation alters the experience of having a dignified life. The aim is to highlight
the impact and how the innovation affects the elderly and their closest stakeholders,
next of kin and care staff.
The measurements are carried out by the elderly themselves, health and social care
staff and/or next of kin together with different academic parts in a multidisciplinary test
process. Products and services can be evaluated from three perspectives; the “care
customers” (elderly or seniors), their next of kin and health and social care profes-
sionals. For evaluation a mixed method is used, to capture quantitative as well as
qualitative measures.
Depending on the character of the tested innovation and its purpose, in the pilot
case two of the perspectives stated above were considered relevant, namely care cus-
tomers and professionals.
Quantitative Method - Questionnaires Regarding Usability. The efficiency and
effectiveness can be measured along with user satisfaction of the innovation to dem-
onstrate potential benefit for current care organization, the elderly sector as a whole or
for personal use [16]. Structured (statistical) data were collected from a number of the
involved staff. The instrument used for this was the System Usability Scale [17, 18] that
measures perceived ease of use. Originally created in 1986, it has become an industry
standard, with references in over 1300 articles and publications. SUS measurement is
intended to cover the products’
• effectiveness (how well a user can complete a task and achieve their goals),
• efficiency (how easy/difficult a user fulfills its goal using the product),
• satisfaction (the level of comfort the user experiences in achieving those goals).
In practical, the SUS measurement consists of 10 statements rated on a 5-point scale
according to how much the user agrees or disagrees with the statement. The result can
be between 0 and 100, higher scores indicates higher perceived ease of use.
Ten persons among the staff who worked with the elderly test persons during the
test period filled out the SUS questionnaire.
Qualitative Method. A qualitative evaluation was made after the test period.
Semi-structured group interviews were conducted with staff that during the test period
had used and worked with the innovation [19]. Interviews were made with groups as it
was more convenient for the staff and easier for them to fit into their busy schedule than
individual interviews. A topic guide was used [19] covering the following three areas:
(1) Information about the respondents (occupation, role in the test, how often you have
used the innovation), (2) Experiences from using the innovation (usability of the
innovation, benefits and problems from the perspectives of staff, the elderly and next of
kin) and (3) Comparison with “practice as usual” (daily routines, effects on the working
environment, advantages and disadvantages).
Data from interviews were analyzed using qualitative content analysis with a
summative approach, where analysis goes beyond mere word counts and also include a
latent content analysis [20].
Pilot Case - Setting and Current Practice. Living lab for the pilot case was a nursing
home for elderly, located in rural areas of north Sweden. The nursing home had 40
residents, all with extensive long term care needs. Nursing services were provided 24/7,
mostly by assistant nurses and care staff with lower education. In addition, there were
three registered nurses with overall nursing- and medical responsibility. Nearly all
residents used absorbent products for protection against urine leakage. This nursing
home already had good routines for investigation of urine incontinence and subsequent
follow-up work, but when the manager and registered nurse were offered to test an
innovative tool they accepted immediately.
Nursing home routines for determining the most suitable protective product for
each individual included a 72-hour measuring period. For each individual the 72 h
measuring period demanded that the staff manually weighted each incontinence
product after use. Weight and time of weighing were documented. After 72 h data was
analyzed in order to figure out voiding patterns and volumes, which were then used as
guidelines when determining which product to choose for each individual.
Pilot Case - The Innovation. The innovation tested as a pilot case in the Living Lab
during November 2014 was a tool for incontinence investigation. The protection
product electronically tracked voiding patterns as they occurred over time, in this case
72 h to compare with standard routines.
The product used sensor technology, where data was transmitted wirelessly to a
computer. Data was then graphically converted into actionable reports, where nurses in
charge of prescribing incontinence products were able to see the exact time and volume
of the individuals’ urination. The disposable protective product was shaped like
a diaper and had a logger device attached to the front. Upon change of product
the logger was disinfected, then attached to a new product (Fig. 2). The purpose of the
innovation was to increase accuracy in incontinence investigations. The purpose of the
product was to facilitate the process of the 72 h test and optimize the outcome of
products to match the needs of each individual.
Fig. 2. Illustration showing the idea of the innovation tested: a disposable protective product
with sensors and logger along with an example of graphic report of data. Picture courtesy of
© Copyright 2015 Svenska Cellulosa Aktiebolaget SCA.
3 Results
Quantitative Results - Questionnaires Regarding Usability. Ten of the staff at the

nursing home, one registered nurse and nine assistant nurses, who participated in the
practical use of the innovation, completed the usability questionnaire. Three were
between 41–50 years and the rest over 50 years, 9/10 had more than 20 years of
professional experience. They were positive or very positive to innovations in care and
very supportive of this innovation. Besides these answers, the SUS questionnaire
revealed their opinions of the usability of the innovation.
The SUS usability score scale ranges from 0 to 100 and the measurement results for
the ten nurses who answered these questions about perceived ease of use of the inno-
vation were 87.5, 100, 100, 100, 100, 65, 60, 72.5, 97.5 and 87.5 in assessing usefulness
of the innovation (Fig. 3). The result of the ten evaluators was well above the average
value calculated on long term use of the scale in situations where the perceived ease of
use has been assessed. That mean is 68. The median of this evaluation was 92.5.
Qualitative Findings. Interviews were conducted with seven persons, representing the
different professions involved with the test. Assistant nurses were mostly involved in
changing the disposable protective product and changing the logger device. The main
Fig. 3. Result of the usability scores of the 10 evaluators
role of registered nurses was to analyze the graphic information. Determining which
protection product that was the most suitable for each person was a team effort
including all professions. In the process of analyses of the measurements a represen-
tative from the company supported the nursing staff and guided them through the
graphical data. Several of the residents participating in this test had dementia and were
not able to give verbal input. Therefore, in this pilot case, the staff acted as proxy for
the elderly in giving information.
Experiences from Using the Innovation. The Innovation was Considered Reliable
and Useful. Handling it was neither technically advanced nor stressful. Removing the
disposable product from the individual was easy, however fastening the product on the
individual was somewhat challenging. To ensure correct fastening it was preferable to
be two persons working together. Changing the logger was not difficult. Graphic
reports were detailed in measuring time and volume for urinating. The staff discovered
that in order to optimize use of data, it was necessary to add specific information about
each individual, such as cognitive status, mobility, medication etc. Data reports were
easy to understand and gave detailed information. The staff appreciated the possibility
to follow leakage activity in real time. By being able to put leakage into a context gave
even further assistance in choosing the right protection for the individual, and even
more valuable in optimizing toilet routines. According to the staff, the residents did not
experience wearing the sensor product as different from wearing their ordinary product.
Staff felt the innovation contributed to improved quality of life for the residents, as it
improved the knowledge about their situation, which was helpful in providing for the
needs of the residents. Next of kin did not participate in this test.
Regarding the perceived usability of the web-based tool, the staff created a detailed
list of potential improvements of the interface and the interaction. The list was fed back
to the responsible of the innovation at the company. Staff from the company also
participated during the evaluation of the test, gathering direct information from the test
participants.
Comparison with “Practice as Usual”. According to the Staff, the Major Differ-
ence Was that They Went from Guessing to Using Facts. Through exact knowledge
about individuals’ leakage they were able to optimize product selection as well as toilet
routines. Some differences between working with ‘practice as usual’ and using the
innovation are displayed in Table 1.
Table 1. Examples of main differences between practice as usual and using the innovation, as
experienced by nursing staff in the living lab.
“Practice as usual” With the innovation
Procedure for Manually by the staff. Protective Continuous and automatic. Data
measuring leakage of products are carried to a regarding leakage is
urine incontinence washroom and weighed on a automatically transferred to the
during 72 h scale. Weight is documented on system, which graphically
paper. Staff exposed to and shows when and how much
handling urine. Time leakage has occurred. No
consuming handling of urine in the
procedure
Precision in data and Absence of precision. Shows total High precision. Shows exact time
measurements amount of urine since last and amount of leakage
measure
Documentation Extensive, time consuming Simple, mostly automatic
Analysis of data Gathering and structuring of data Gathering and structuring of data
is handled manually for each is handled automatically for
person. Overview of each person. Easy to compare
measurement is lacking registered information of a
person to new information as
graphically displayed
Knowledge about the Data forms the basis for A decision support tool. Precise
needs of the resident assumptions about needs data gives knowledge about the
needs of residents. Facilitates
the transparency of taken
decisions
The analysis of gathered data led to the following changes for the five test par-
ticipants: change of the routines occurred in four occasions and change of product
occurred in three occasions, all of them to a thinner product.
4 Discussion
Norrlandicus’ test environment and method are based on the conceptual idea that staff
and the elderly in each living lab are the ones providing measures regarding an
innovation’s success in enhancing quality of life for the elderly. Each innovation
(product, service or process) needs to be assessed using quality measures from the
users’ point of view. In the pilot case described above the authors wanted to test the
method and see if it was possible for the elderly and their care staff to conduct the tests
in their natural environment, the Living Lab. We found that the participants were able
to provide relevant measures of the innovation. Initially we had anticipated a higher
level of information input from the elderly themselves. We may need to re-think how to
capture the experiences from the elderly. Using staff or next of kin as proxy may be one
way to go, although another study by one of the authors [7] points out the need to allow
end-users to participate in the evaluation of the innovation based on their own capacity.
This dilemma will be further research and future work within the Norrlandicus Living
Lab. This also brings some ethical considerations. Conducting research in settings
involving vulnerable subjects is an ethically complex issue. In nursing homes and other
forms of elderly care, where the Living Labs are situated, there are several individuals
with dementia in the test population. As an actor in close cooperation with nursing- and
social sciences, Norrlandicus follows common ethical guidelines [21]. Participation in
tests was voluntary. Prior to inclusion in the tests, all participants gave written consent.
For participants with dementia, next of kin gave written consent. Another ethical issue
to consider was the heavy work load at nursing homes. For Norrlandicus it was
essential to minimize disturbance for the staff as well as the residents. Organizing the
test, with meetings and research activities in adjustment with staff and resident
schedules, shift work and a rather high staff turnover was a time consuming challenge.
Further, healthcare to date has been focused on service for illnesses rather than
addressing citizens’ holistic health needs, including e.g. social services, prevention and
support for informal care givers [22]. In recent publication, researchers call for the
inclusion of social care informatics as an essential part of holistic healthcare, stressing
the importance of this emerging field of research [23]. In order to strengthen the role of
patients and next of kin, this method focuses on patient-centric provision of care,
following the ongoing shift from organization to citizen-centered care [24]. The
usability of the intended innovation is another quality measure, a key to failure or
success of a product [25].
The expected result from an academic point of view was that Norrlandicus test
method as such was validated. The aim is to measure the contribution of the innovation
in terms of “Dignity of Life” for the elderly as well as the degree of usability of the
innovation. The “Dignity of Life” criteria need to be measured a while after the
changes of routines and products have been made and is hence part of the work that lies
ahead of us.
Although there is a national initiative supporting deployment of test arenas, it is still
not common that test arenas use qualitative values to evaluate the benefit of the tested
innovations as is the case of our test method. This method has already attracted interest;
however it is yet to experience whether other test arenas will seize the opportunity and
start using the Norrlandicus test method.
Expected results from the innovators and the aging society may vary depending on
type of innovation. As this method focuses on the quality of life of the elderly and
allows for interaction between industry, health and social care and academia there is
some ground to claim that the Norrlandicus Living Lab can support in providing real
health and social care improvements via technical innovations.
5 Conclusion
Norrlandicus is an open innovation and test arena aiming to meet tomorrow’s needs
and contribute to increased quality in healthcare and care for the elderly. In the Living
Lab private and public stakeholders are invited to evaluate innovations (products,
services and processes) using the Norrlandicus method to determine if they add
increased value in a health and social care process for the elderly and to measure to
what extent the innovation is perceived useful by the end-users. The success factor lies
in the joint testing work between the elderly, the nursing staff and the research team
with different specialties. In short, the test method examines the introduction of an
innovation in the local environment of the elderly and whether this intervention alters
their experience of having/getting a dignified life, while at the same time the method
also assesses the usability of the innovation. Future work is to continue refining the test
method by conducting pilots and field studies to gather knowledge and experiences
from different stakeholders in the aging society.
Acknowledgements. We would like to thank all participants at the nursing home Vikto-
riagården in Kramfors, Sweden, for their work and engagement. We would also like to thank the
representatives of SCA Hygiene Products AB for good teamwork and for providing the inno-
vation TENA IdentifiTM for pilot testing as well as Pär Näslund and Katarina Palmgren for their
field work. Finally we thank the Swedish agency for innovation systems, VINNOVA and the
County Administrative Board in Västernorrland for financing the research and development
project Norrlandicus.
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Talking Faces in Lab and Field Trials
A View on Evaluation Settings and User
Involvement Results of Avatar Based User
Interaction Techniques in Three Ambient
Assisted Living Projects
Miroslav Sili1(&), Jan Bobeth2, Emanuel Sandner1, Sten Hanke1,

Stephanie Schwarz2, and Christopher Mayer1
1
Health and Environment Department, Biomedical Systems, AIT Austrian
Institute of Technology GmbH, Vienna, Austria
[email protected]
2
Innovation Systems, Technology Experience, AIT Austrian Institute
of Technology GmbH, Vienna, Austria
Abstract. In recent years, there has been an increasing interest in Ambient

Assisted Living technology to support older adults. Research and industry are
working jointly on reliable and suitable solutions to help older adults to remain
healthy and safe while living independently. Appropriate interaction methods
play an important role for the acceptance of such supporting systems. Today,
solutions mainly rely on common and well-evaluated interaction techniques
such as TV remotes or touch screens to enhance the usability. Projects presented
in this work are based on the same interaction techniques, but additionally
enrich the interaction experience with a real-time, empathic virtual assistance
avatar. In this paper, we present evaluation settings and user involvement results
acquired from three different Ambient Assisted Living projects focusing on
avatar-based user interaction. Our results show that avatar-based interaction in
the Ambient Assisted Living context is very well applicable, especially when
combined with speech recognition.
Keywords: Avatar User interaction Ambient assisted living Multimodality
1 Introduction
This work summarizes evaluation results of prototypes developed in the projects

AALuis1, ibi2 and Miraculous-Life3 with special focus on avatar aspects. We present
lab and field trial outcomes from the accomplished projects AALuis and ibi as well as
interim lab trial results from the still ongoing project Miraculous-Life. All three
1
http://www.aaluis.eu.
2
http://www.ibi.or.at.
3
http://www.miraculous-life.eu.

DOI: 10.1007/978-3-319-20892-3_14
Talking Faces in Lab and Field Trials 135
projects use avatar-based output in order to support the end user during the interaction
with the system. Prototypes developed within the ibi and Miraculous-Life projects also
include speech recognition, thus allow a smooth user-system interaction.
The prototypical outcome of AALuis is an open middleware layer that can be used
to connect various AAL services to a variety of devices with the help of automatically
generated user interfaces [1–4].
The overall goal of the ibi prototype is to provide a tailored communication plat-
form which is easy to understand and which can easily be used by three target groups,
namely older adults, their relatives and professional caregivers.
The aim of the Miraculous-Life project is to design, develop and evaluate a Virtual
Support Partner (VSP) assisting older adults throughout their daily activities and safety
needs [5].
2 Methodology
To guarantee high usability and user acceptance we followed a user-centered approach

in all three projects [6]. User involvement took place in the concept phase as well as in
the two prototype evaluation phases. This section gives an overview about the eval-
uation settings, the involved user groups and the evaluation methods.
2.1 Phase One: Evaluation Settings During the Concept Phase

Before the first phase, user wishes, needs and requirements were collected with the help
of cultural probing. Results were discussed in several workshops to identify the needed
functional requirements for the planned prototypes. Afterwards, we involved different
user groups into the design process by discussing scenarios and conducting usability
studies (e.g., thinking aloud [7, 8]) with early mock-ups. Additionally, service devel-
opers and providers, user interface designers as well as experts from care organization
helped to classify requirements and to identify usability problems in the early devel-
opment stage. Table 1 shows a comparison of the evaluation settings from the projects.
2.2 Phase Two: Evaluation Settings for the Lab Trials

The second phase was conducted in a similar way as the first phase. Different user
groups evaluated the first running prototypes which already covered most of the pre-
viously defined user requirements. A limitation on functionality and offered services
during the lab trials allowed us to rather focus on general system characteristics like
usability, performance, complexity and efficiency. Table 2 summarizes the evaluation
settings during the lab trials.
2.3 Phase Three: Evaluation Settings for the Field Trials

In this phase, final versions of the prototypes were tested during a period of 2 to 6
weeks. Since Miraculous-Life is still an ongoing project, we evaluated only two of the
136 M. Sili et al.
Table 1. Comparison of evaluation settings during the concept phase
AALuis ibi Miraculous-Life

Period Dec. 2012 – Jan. 2013 Nov. 2012 – Feb. 2013 Mar. 2014 – Sep. 2014
Participants 12 26 41
Sex F/M 7/5 16/10 25/16
Average age 74.5 70a 79.7; 50.2b; 32.5c
User groups Older adults, younger Older adults, informal Older adults, formal and
& active seniors caregivers informal caregivers,
experts
Methods Structured interview, Structured interview, Structured interview,
task-based empirical task-based empirical questionnaire, expert
investigation, System investigation, walkthrough [10],
Usability Scale SUS[9] questionnaire heuristic analysis [11]
Devices Smartphone, PC, tablet, Smartphone, tablet, PC, tablet, kinect
TV TV
a
Age calculated based on the average value of the estimated participants age
b
Formal and informal care givers
c
Experts
Table 2. Comparison of the evaluation settings for the lab trials

Period Apr. 2013 Feb. 2014 Sep. 2014
Participants 9 17a 18
Sex F/M 3/6 4/3b 13/5
Average age 71.2 72.1b 81.71; 45.6b
User groups Older adults, younger Older adults, informal Active older
& active seniors and formal caregivers adults, formal caregiv-
ers
Methods Task-based empirical Task-based empirical Task-based empirical
investigation, SUS investigation, post- investigation, think
interviews, question- aloud method, ques-
naires tionnaire (SUS)
Devices Smartphone, PC, Smartphone, tablet, TV PC, tablet, Kinect
tablet, TV
a
Sex and age of users in the user group older adults have not been elaborated
b
Formal and informal care givers
Table 3. Comparison of the evaluation settings for the field trials

Period Apr. 2014 – Aug. 2014 Jul. 2014 – Aug. 2014 Jan. 2016 – Jul. 2016
Participants 46 8 /
Sex F/M 33/13 4/4 /
Average age 82.8 68.9 /
User groups Older adults, younger Older adults /
& active seniors
Methods living lab setting Log files, media diary, /
interview
Devices Smartphone, PC, Smartphone, tablet, /
tablet, TV PC, TV
three projects in a natural setting. Table 3 presents the evaluation settings of the
AALuis and ibi project during the field trials.
3 Evaluation Results
Although all three prototypes use avatar based interaction technology, the main goal of
each project is different. However, the presented projects also share various numbers of
comparable aspects. The following section focuses on theses comparable aspects but
also on project specific findings.
3.1 Evaluation Results from the Concept Phase

Project Specific Findings
AALuis. The group of healthy and active seniors assessed early mock-ups of the
AALuis communication service using a laptop and a smartphone. In general, partici-
pants reported that the usage of the service was easy for them. One person noticed that
it would be interesting if appointments would synchronize automatically with the
calendar on their smartphone or PC. There was also the fear to get too dependent on a
mobile device in terms of being available all the time.
Older adults evaluated mock-ups of the AALuis reminder service using a tablet and
a TV in an assisted living center where we set up a mobile usability lab. For both
versions, we could hardly detect any clear usability issue. Nevertheless, some partic-
ipants had problems interacting with the prototypes. One reason was that the partici-
pants were not familiar with the used remote control. The buttons were too small and it
was perceived as too complex. Furthermore, participants were hesitant to touch the
tablet and had problems to activate a button. They were too hastily or pressed too hard.
Sometimes the system did not recognize these touches and the supervisor guided their
fingers by hand. It was not possible to test the avatar in this early stage because the
development of this module was still ongoing.
138 M. Sili et al.
ibi. In this early phase, the ibi system was represented by two functional mock-ups
implemented on the tablet and on the TV. Users liked the simple designed GUI con-
taining three areas (avatar area on the top, textual representation of the spoken dialog in
the middle and the interaction area with maximal three buttons on the bottom). Par-
ticipants emphasized that it was very helpful to see the textual representation of the
spoken dialog. These users preferred to read the presented contend instead of listening
to the avatar. The interaction using the four colored buttons on the TV remote control
was easy and intuitive enough for almost all participants.
The used speech recognition model, which was originally designed for seniors
using the Styrian dialect, was also appropriate enough for the testing group of Viennese
citizens. Participants perceived the vocal interaction with the system as something
natural. Users emphasized that they liked the speech recognition because they would
not need to put their glasses on to be able to read a message from their relatives.
Investigation on the avatar appearance showed that participants prefer a human like
middle-aged female avatar which is dressed in everyday clothes and which interacts in
a private surrounding like a living room.
Miraculous-Life. Older adults as well as formal and informal caregivers assessed the
basic functionalities and avatar mock-ups early on in the project. Based on the eval-
uation results, a first prototype with reduced functionality was tested by experts on a
tablet. Avatar mock-ups in conjunction with a questionnaire revealed that the avatar
should act as a friendly personal assistant. Furthermore, most users preferred a human
like avatar with a young woman’s appearance. The avatar should indicate different
interaction modes like waiting, listening and talking.
The expert group analyzed the avatar interaction and the available services. It was
found that the dialogues used with the avatar should be more friendly and natural when
addressing the older adults. The avatar was considered to have a clearly understandable
speech output. Some issues were reported on behalf of wrong pronunciation and
intonation of certain words and letters, especially when using the French language.
Furthermore, strange system behavior was observed where the avatar was arbitrarily
giving commands to himself. This happened because the speech recognition module
recognized certain commands given by the avatar while presenting new information.
Apart from the avatar analysis, the experts noticed some inconsistencies in the
service workflows, especially regarding the navigation. Additionally, experts found that
sometimes the system response time after issuing a command was too long.
Summary of the Evaluation Results
Table 4 provides a comparison of the evaluation results during the concept phase using
rating scales. Ratings were performed by project experts based on the empirical find-
ings from the user involvements.
Implications for the First Prototype
AALuis. At the smartphone version targeting the healthy older adults, some interaction
elements like radio buttons and tabs were too close together and the navigation area
should be visible all the time. Some older adults struggled with using the tablet because
they used a touch screen for the first time and did not dare to really touch the screen.
Table 4. Overview of evaluation results from the concept phase. Rating scale interpretation:
Entries on the left side of the vertical line indicate usability or understanding problems, entries on
the right side indicate better usability and understanding.
AALu is ibi Miraculous-Life

GUI usability
Service understanding
Interaction on the smartphone not tested not applicable

Interaction on the tablet
Interaction on the TV not applicable

Speech recognition not applicable
Avatar appearance not tested
Therefore, a training period for this target group had to be considered. The standard
remote control for the TV version confused some participants due to the high amount
of unnecessary buttons, thus later on a simplified version was used.
Ibi. Intended services for the first prototype needed to be reconsidered based on the
questionnaire results performed in this phase. Not all users were familiar with the touch
based interaction so they required a training period. The presented avatar also had to be
redesigned, because users preferred rather a female, middle-aged avatar.
Miraculous-Life. The avatars text pronunciation and intonation had to be improved so
that the older adults do not have problems understanding the avatar. Moreover, the
speech recognition had to be disabled during the avatar playback in order to prevent the
avatar from activating actions through spoken commands. The service workflow
needed also improvements to yield a consistent flow of information and navigation.
3.2 Evaluation Results from the Lab Trials

AALuis. The group of healthy and active seniors evaluated the first functional proto-
type of the AALuis communication service using a PC and a smartphone. In the
beginning, 4 of 5 participants felt more comfortable using the application on the PC,
but 3 of 5 participants got used to operate the smartphone rather quickly. Nevertheless,
when the participants were asked which device they would prefer to use, 4 of 5 favored
the PC. Despite some usability problems, participants gave positive feedback to the
well-structured and similar layout of the application on both devices.
The participants in need of care assessed the AALuis reminder service on TV and a
tablet. In general, usability of the AALuis reminder service was restricted since all
140 M. Sili et al.
participants had general problems with the TV navigation and were not familiar using a
touch-based device. Since participants had no experience with touch screens and
mostly refused to use them, 3of 4 participants preferred using the TV compared to the
tablet.
ibi. Although the speech recognition was not implemented into the first prototype,
some of the users intuitively tried to respond vocally on questions asked by the avatar.
After a short clarification and some hints about interaction possibilities, most of the
users were able to confirm the presented dialogs by using the TV remote control. Two
users felt a little bit uncomfortable and insecure, hence they refused the interaction with
the remote control.
Care receivers had problems to confirm messages on the tablet. They were not used
to tablets and were not familiar with the concept of touchable buttons. The device was
also not sensible enough and users had to click buttons multiple times in order to
trigger an action. Informal and formal caregivers had troubles with the smartphone,
trying to activate the on-screen keyboard. Additionally, typing on the small screen was
perceived to be a difficult task.
Miraculous-Life. The overall impression of the system was positive and the end users
found the provided services useful. Two users suggested that the Miraculous-Life
system could be an interesting solution for older adults who live alone at home. On the
contrary, other end users suggested that the VSP is a “tricky solution”, since it could
potentially encourage social isolation.
While the avatars speed of speech was adjustable, a similar feature for adjusting the
volume was missed by the end users. Furthermore, the end users missed the possibility
to skip an avatar video. Many participants did not know when the system accepted the
next command and wondered why the system would not react on their behalf. Addi-
tionally, the users found that the speech recognition was not always accurate, which
lead to an unexpected system behavior.
Two older adults experienced difficulties hearing and understanding the avatar.
Furthermore, the gestures of the avatar were perceived to be fluent and fit to the spoken
words but the repertoire was too limited to simulate a natural interaction.
Regarding the user interface, older adults stated that the buttons and labels were too
small to read. Additionally, the avatar was considered to be too small in the service
view and too big in the main view.
Table 5 presents an overview of the evaluation results from the lab trials using rating
scales.
Implications for the Second Prototype
AALuis. Evaluation results from the second phase indicated that the mock-ups were
easier to use by the participants than the prototypes. Thus, for the final prototypes the
automatically generated user interfaces needed to be closer to the mock-ups taking the
findings of both reported evaluations into account. While some aspects of the proto-
types should be solved with better user interface templates (e.g., better highlighting
of the focused UI element), other aspects required updates within the underlying
Table 5. Overview of evaluation results from the lab phase
AALu is ibi Miraculous-Life

GUI usability
Service understanding
Interaction on the smartphone not applicable

Interaction on the TV not applicable

Interaction on the laptop not tested not applicable
Speech recognition not applicable not tested
middleware layer (e.g., the differentiation between headline and normal text). The
creation of a UI template for each device was considered to be a solution to reduce
some of the device-specific usability issues.
ibi. The usage of a remote control beyond the TV context was for some users
unnatural. They needed time to get familiar with this interaction type. Additionally, the
remote control had to be simple and clearly designed in order to increase user
acceptance. High quality and more sensible tablets were required. The application for
the informal caregivers had to be redesigned. Predefined text blocks should help to
eliminate the need for typing and to speed up the message generation process.
Miraculous-Life. Since the Miraculous-Life project is currently under development,
the following improvements have to be implemented in the final prototype. The UI has
to be redesigned by means of avatar size, element contrast and coloring to meet the user
requirements and suggestions. The usage of external speakers to better understand the
avatar rather than using the built-in ones needs to be assessed further. The current
interaction mode of the avatar must be clearly visible and perceivable. Furthermore, a
possibility to skip an avatar video is desired. The speech volume must be adjustable
directly from the UI by spoken commands. Finally, the system latency has to be
reduced significantly.
3.3 Evaluation Results from the Field Trials

AALuis. We found that many participants of both user groups appreciated the idea and
the services offered by AALuis. However, using the prototype was inferred from time
to time by technical problems. Accordingly, the user experience results did not reflect
the positive attitude towards AALuis. While the healthy and active older adults got first
of all frustrated, the persons in need of care became more insecure and sometimes
did not dare to use the service anymore. Nevertheless, many participants uttered their
142 M. Sili et al.
regrets that they could not use the services more often to benefit from their offers.
Positive experiences of users which faced only a few technical problems suggest that
a fully functional product offering these services might be interesting for the two
involved user groups.
ibi. In general, all participants were satisfied with the functionality and the benefits of
the offered services. In some cases the internet connection was not as stable as
expected, therefore some messages were delivered with an evident delay.
Users appreciated the possibility to interact with the system using multiple devices.
Hence, many users combined these devices, e.g., by starting the dialog on the tablet and
continuing the interaction by using the avatar-based TV output and the speech rec-
ognition. The overall impression of the speech recognition was quite positive.
Unfortunately, a few numbers of dialogs were automatically confirmed by the con-
tinuous activated speech recognition. Sources of noise, like the radio speech, triggered
commands on the system without explicit intention from the users.
Informal and formal caregivers reported that it was sometimes difficult to use the
smartphone because of the small screen size. Furthermore, the problem with the
insensitive tablet devices remained. It was not possible to purchase new devices for
the field trials so the lab trial devices had to be reused. Informal caregiver remarked that
it would be practical to have an automatic synchronization between the ibi calendar and
a private calendar, e.g., on the smartphone.
Table 6 summarizes the evaluation results during the field phase using rating scales.
Implications for Further Improvements
AALuis. Developers have to make sure that the technical setup and the system per-
formance can be guaranteed in terms of stability of the integrated system, functionality
of all components, and suitability of the external conditions such as sufficient network
Table 6. Overview of evaluation results from the field trials
a
Overall usability
Service satisfaction
System reliability
Interaction on the smartphone
Interaction on the TV
Interaction on the laptop
Speech recognition not applicable

a
The Miraculous-Life project has not been evaluated in the field so far.
coverage. Apart from these technical issues, the avatar was well appreciated, especially
by the older adults. It would be good to offer more control possibilities to the users in
terms of replaying, pausing or stopping the avatar. Other AALuis UI elements would
benefit from a more visually appealing graphic design which also requires adjustments
in the middleware layer.
ibi. The speech recognition must not be activated all the time but just by special
activation commands, e.g., by the name of the used avatar. Formal caregivers, who
mainly used the smartphone, need a smarter solution to announce a delay of the
home-care visit. Neither the typing of a delay message, nor the selection of a predefined
text-message are appropriate options for this task on small smartphone screens. As an
improvement one can, e.g., use location based services and a scheduler to automatically
pre select the user and the message for a delay announcement. Older adults require
devices with an acceptable touch sensibility. Therefore, touchable devices have to be
pretested before the deployment. For the informal caregivers, automatic calendar
synchronization could be a practical feature.
4 Conclusion
In this paper, we present evaluation results of avatar-based supporting systems developed in

three different Ambient Assisted Living projects. Prototypes developed in the projects
AALuis and ibi generally use an avatar but the focus is rather on a versatile interaction with
different modalities on different devices. In contrast, Miraculous-Life strongly focuses on
the avatar as a virtual interaction partner and not on modality and device diversity. However,
results from all three projects showed that avatar-based interaction in the Ambient Assisted
Living context is very well applicable. This kind of interaction, especially when combined
with speech recognition, offers big advantages for the target group.
Acknowledgments. The project AALuis was co-funded by the AAL Joint Programme (REF.
AAL-2010-3-070) and the following National Authorities and R&D programs in Austria, Germany
and The Netherlands: BMVIT, program benefit, FFG (AT), BMBF (DE) and ZonMw (NL).
The ibi project was co-funded by the benefit programme of the Federal Ministry for Transport,
Innovation and Technology (BMVIT) of Austria.
The Miraculous-Life project is co-funded by the European Commission under the 7th
Framework Programme (Grant Agreement No 611421).
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Gamification and Accessibility
Andreas Stiegler(&) and Gottfried Zimmermann
Responsive User Interface Experience Research Group, Stuttgart Media

University, Stuttgart, Germany
[email protected], [email protected]
Abstract. There are many software requirements for the development of

accessible applications, in particular for elderly people or people with disabili-
ties. In particular, user interfaces have to be sufficiently abstract to cover
required adaptations. In this paper, we introduce a gamification approach for
teaching, connecting and engaging developers on accessible design of appli-
cations. A particular challenge hereby is combining gamification patters with the
requirements of accessibility. As many gamification patters build on visual
representation or usage metaphors, they are not suited for adaptation. Instead,
we derive a representation-agnostic set of gamification patters from actual game
design of commercial games. We identify and illustrate five categories of
representation-agnostic gamification patterns, based on a games survey: action
space, reward, challenge, progress, and discovery.
Keywords: Human computer interaction Gamification Accessibility

Elderly Game development Serious games Game design Game
mechanics Game theory
1 Introduction
A particular challenge for computing and aging is supplying applications that are
adaptable and configurable enough to support simplified or modified user interfaces or
usage metaphors. Adaptations can be quite simple, for example coloring or size, but
can also be very complex modifications on content, such as simpler text or altered
usage metaphors and timeouts [15].
There are various technical approaches to adapt an existing application, either
through the application directly or through interface abstraction layers as supplied by
the operation system or window manager. Yet, adaptations regarding usage metaphors
or deeper adaptions regarding the visual representation can usually not be covered by
those approaches, as they require an application to have a sufficient API to inject new
interface models.
The Prosperity4All project [11] therefore aims at software developers, supplying
them with resources, documentation and online help texts to integrate such approaches
into their software project. An important piece of the Prosperity4All approach is the
community server, which serves as a platform for developers interested in providing the
necessary adaptations for their application. The community server uses gamification to
increase acceptance. The challenge herein is to combine gamification techniques and

DOI: 10.1007/978-3-319-20892-3_15
146 A. Stiegler and G. Zimmermann
accessibility constraints. As most common approaches of gamification focus on visual

representation, those are unsuited for an accessible platform. Our approach is derived
from analyzing gameplay and game mechanics patterns of popular games, deriving
representation-independent gamification models.
2 Gamification
Gamification has been described as using elements of game design in non-game

contexts [1]. The core idea is to identify the mechanics that make people enjoy a certain
process [2]. It has been shown that people enjoying a process are either more pro-
ductive in executing said process, or more careful in maintaining external constraints
[3]. As such, gamification is not a single, precisely defined method, but rather a
methodology to transfer knowledge from the games industry and utilize it to optimize
and enrich non-game processes [1].
Both physical and computer games offer patterns that are supposed to make player
actions enjoyable [5]. Some patterns, such as clearly defined rules, are often shared
between both categories of games. Some are unique to either environment. As our
research is focused on creating a purely virtual platform for software developers and
combining this virtual platform with accessibility for virtual devices, we will focus on
computer games and the metaphors used for gamification in virtual worlds.
Since first research in the 1980s, such as [4], gamification became a powerful and
popular tool for both academia and industry. Nowadays, gamification is often intro-
duced as a method to add additional benefit to a business process without actually
altering the business process itself [8]. Following this logic, it is important to note that
gamification should always be optional [7]. As soon as a user is forced to participate in
a gamification system, the gamification system becomes part of the actual process
gamification is trying to improve. For most applications, however, the business process
should remain as fast and efficient as possible, without taking gamification elements
into account. Gamification aims at the user, not at the underlying process. Yet,
deploying gamification to a business process can lead to the discovery of shortcomings
and ineffective sections of the respective business process and should then lead to
alterations and improvements.
Our research focuses on three aspects of gamification: gamification used for
teaching, gamification in complex application interfaces and gamification used for
self-organization and coordination. We will illustrate the problems of combining ga-
mification used for teaching and accessibility in this paper.
2.1 Gamification for Teaching

Gamification can be used to improve the process of learning, resulting in faster or more
reliable knowledge consumption [5, 6]. This is of particular interest to us, as many
developers have to be familiarized with the problems and issues of accessible software
design. The GPII [11], for example, requires a software developer to express their
application settings in a certain way, or to integrate interfaces to GPII components for
runtime adaption.
Gamification and Accessibility 147
Particularly for learning, gamification and serious games blend [9], and there is no
clearly defined, sharp line between them. Many learning systems or games build on
reward messages (for example by using success messages, such as used by Anki [10])
or extrinsic motivation via measurable reward points (such as school grades). The
process of learning is very individual and not tied to specific software or patterns.
Reward in learning applications often comes in the form of high-scores, badges, un-
lockable achievements or other features like customizable avatars. Reward-based ga-
mification approaches – or serious games – have to face various problems when
combined with accessibility, as described in the following chapters.
3 Gamification and Accessibility
One of the core requirements of gamification is to be optional and not distracting from
the gamified core task [7]. In graphical user interfaces, this is often achieved by placing
the visual representation of reward in a sidebar where it is not visually distracting.
Further visual techniques can be used, such as color-coding or visual styles to clearly
mark the gamification part of the user interface. As argued in [13], this can work well
for two-dimensional user interfaces. Yet, it is obviously tied to a specific form of
representation. Even simple modifications, such as zooming, can cause the sidebars to
consume a more significant portion of the screen space; altering the color settings, such
as contrast, can render color coding ineffective; icons and symbol graphics can be
meaningless to some audiences. For more complex modifications, such as using a
screen reader, the drawbacks of gamification relying on visual representation become
obvious. A screen render uses a one-dimensional representation of a document, such as
a web page, to read it to the user. In contrast to a two-dimensional user interface, there
is no simple way of arranging a user interface element in a way so that it is present, but
not distracting. A gamification interface previously placed on a sidebar will end up at
the beginning, the end, or somewhere else in the one-dimensional stream of repre-
sentation. This will force a user to either skip those parts when reading a document,
clearly violating the prerequisite of optional gamification.
One approach to overcome those limitations is to create explicit gamification
alternatives for each possible interface modification. Taking the vast amount of pos-
sible interface modifications into account, such an approach becomes impractical. Yet,
there are gamification approaches that work without relying on their visual represen-
tation. These representation-agnostic elements of gamification are typically of a more
abstract nature and are harder to identify.
3.1 Identifying Representation-Agnostic Gamification Patterns

In order to derive gamification patterns that do not rely on their visual representation,
we analyzed a collection of 21 commercial PC games for their game play and game
design. The analysis was conducted through interviews of a variable number (2–6) of
experienced players per game. The findings were further categorized into gameplay
patterns. Game design and game mechanics considerations were taken into account
where feedback from the game developers was present. An interesting finding was that
similar or even identical patterns can occur in variable contexts for different effects.
Instead of forming a fixed set of gamification patterns, we therefore assembled a pool of
patterns that can be applied to different scenarios. The following chapter will highlight
some of them with a respective game example.
4 Gamification Patterns
The representation-agnostic gamification patterns derived from the games survey can
be grouped into five major categories: action space, reward, challenge, progress, and
discovery. This chapter will illustrate each of them with an example from the survey.
Fig. 1. Tetris on the Nintendo Game Boy (1989)
4.1 Action Space: “Tetris”

Tetris is popular puzzle game dating back to 1984. As such, it formed the foundation of
gameplay mechanisms for many generations of puzzle games to come. Both the
gameplay and rules of the game are very simple but addictive. Due to the simplistic
game design, the mechanisms that make Tetris fun to play are clearer to identify. One
category in which Tetris shines is a fully observable and small action space (Fig. 1).
The action space of a problem is the number of options per decision a user can
select from. There are multiple aspects to the action space that are relevant to making a
game enjoyable. First off, the action space of Tetris is fully observable: The player is
aware of all possible actions they can do at a given point of time: rotating blocks
clockwise or counterclockwise, moving blocks left and right or accelerating their
descent. More importantly: A player knows that they know the complete action space.
This is a sharp contrast compared to many business tasks, where the action space is
typically vast (filling out documents has a giant action space, but even the average
document processing software offers dozens of options just to style the text). In our
survey, users enjoyed selecting from a small collection of options. In many office
applications, one can observe a trend of shifting programming problems into the action
space of a user. A typical example are dialogues like “You are performing an action
that you cannot undo, are you sure?”. Instead of implementing a reliable undo function,
the problem was moved to the user, unnecessarily expanding their action space.
The other interesting aspect of the action space of Tetris is that users not only know
the complete action space, but they are also aware that they know the complete action
space. There are no advanced or hidden commands in Tetris that allow any other
interaction, besides going to the menu and ending the game. In many applications, on
the other hand, user actions are grouped into actions a user often wants to do, and
advanced settings only used for specialized tasks. Yet, this seems to reduce the joy in
performing those actions, probably as users are uncertain if they actually picked the
best possible action, or if there would have been a smoother way to solve a problem
hidden in some advanced menu. Applications should therefore be designed in a way to
require as few actions as possible, so that all can be presented to a user. This is
unrealistic for complex software, like an image editing program, but interface structures
could be arranged in a way, so that for a certain problem – like applying a blur-effect to
an image region – all possible actions are presented.
A small and fully observable action space, with the knowledge of being fully
observable, is a base principle in all the games mentioned in this paper.
4.2 Reward: “Diablo III”

Diablo III is a hack’n’slay game where a player ventures through a dark fantasy world
and slays demons and other creatures and solves challenges. As with many examples of
this genre, one of the most important gameplay concepts is acquiring new equipment to
defeat stronger foes. Many games use specific reward models to distribute and handle
rewards for players. Reward in games fulfills a few important characteristics different
from real-life: being immediate, measurable and expectable (Fig. 2).
Fig. 2. Diablo III from Blizzard Entertainment (2012)

In games, reward is usually given right after the action that caused it, unlike
real-life examples, where rewards – or penalties – are often distributed a long time after
the action that triggered it. That makes it hard for users to associate the reward with the
actual action and therefore decreases the probability to trigger a positive feedback
cycle. Defeating a difficult enemy in Diablo III will immediately reward new equip-
ment, similar to the lines in Tetris immediately disappearing once they are filled.
Similarly, reward in games is usually measurable and comparable. Reward is
sometimes just awarded in non-measurable form, like a “Congratulations” message, but
in most games, players gain score – as in Tetris – or measurable improvements to
character attributes – as in Diablo III. This is important to compare different rewards
between alternative actions. These metaphors are already used by gamification a lot, as
high scores and reward points are a very commonly used gamification pattern.
Also, reward in games is often expectable. That means, that the rules that may yield
a reward are clearly communicated to the players. This goes along with the fully
observable and known action space discussed above.
4.3 Challenge: “Portal 2”

Portal 2 is a first-person puzzle game where the player has to solve a wide variety of
physics puzzles, utilizing the conservation of momentum, gravity and fluid mechanics.
The puzzles become more challenging throughout the game and are very challenging, if
compared to other puzzle games (Fig. 3).
Fig. 3. Portal 2 from Valve Corporation (2011)
The design and dramaturgy of designing challenge is an essential part in game

design. A common approach is game flow [14]. Game flow is a concept of keeping
challenges offered by the game in check with the skill progression of the player. From a
more abstract perspective, game flow is dealing with learning effects of the user. One
example of applying flow to gamification for elderly was demonstrated by Korn [16].
Challenge in games and in gamification is very different. In games, challenge can

be designed and planned, as the underlying game mechanics, story, and gameplay can
be altered. A boss encountered deemed to be too difficult can be made easier by
offering assistance to a user or reducing the capabilities of the other non-player char-
acters. When dealing with challenge in gamification, the challenge is often implied by
the business process being gamified. In that case, challenge cannot be designed freely.
Yet, gamification approaches might introduce their own challenges, for example by
adding mini-games, such as a puzzle where each solved work-task allows performing
an action in the puzzle. In that case, the mini-game can be considered a full-fletched
game, with all possibilities of game design, with the only difference that the action
space of the mini-game is bound to a real-life business task.
If utilizing challenge in gamification, it goes along with action space and reward, as
described above. A challenge in a game has to be solvable with a fully observable
action space and should offer some kind of reward.
4.4 Development: “World of Warcraft”

The core principle behind Massively Multiplayer Online Role-Playing Games
(MMORPGs), such as World of Warcraft, is the ongoing development of a character.
This is very similar to many real-life scenarios, where most actions come with per-
sistent, ongoing consequences (Fig. 4).
Fig. 4. World of Warcraft from Blizzard Entertainment (2004)
According to the survey, an important requirement for players to perceive a per-

sistent development of a character as enjoyable is, that such a development is clearly
measurable. This seems to be a consequence of measurable progress as described
earlier. Persistent development shares most of its requirements and aspects with
progress, but does not require reward to be enjoyable. In a sense, the persistent
development itself can be sufficient reward for players to continue playing, as they see
constant improvements. Many MMORPGs exploit that to an extreme extend, as those
games typically don’t offer any kind of ultimate goal in the game. You can never win
an MMORPG. Instead, the developer supplies new options to improve your character,
and it is only possible to achieve a perfect setup by investing a lot of time (or money).
Persistent development is related to progress and challenge and can serve as a form
of intrinsic reward.
4.5 Discovery: “Elite: Dangerous”

Curiosity and – associated with it – discovery can be very powerful and driving reasons
to perform an action. Many open world games offer very fast virtual environments,
which allow players to explore. In Elite: Dangerous, a player can discover our whole
Milky Way galaxy with countless solar systems and planets, some of them inhabited
(Fig. 5).
Fig. 5. Elite: dangerous from frontier developments (2014)
In order to be enjoyable, the survey showed that virtual worlds to be discovered

have to be consistent both in regards to the rules they imply (such as gravity or the laws
of magic) but also – and more importantly – in regards to their story. This can either be
an overall story of the game universe, or just small stories originating from character
interaction. Tailoring a vast consistent game world is a challenge.
While discovery can be very motivating, the underlying requirements of discovery –
a vast virtual world – are usually not fit for gamification. Some serious games utilize this
technique, but for the average gamification task developing a while virtual world is not
an efficient approach.
5 Conclusion
In this paper, we have discussed the five primary gamification aspects that the game
survey revealed: reward, action space, progress, development, and discovery. All of
them are rather abstract concepts of game design and don’t rely on a certain visual
representation. One could, for example, think of an action space represented in a 2D
visual display, or explained through a screen reader. Such representation-agnostic
metaphors are the fundamental building blocks when setting up a gamification
framework supporting accessibility.
Future work will focus on deriving discrete representations for the patterns we
discovered. They will be utilized in a community server platform for the GPII helping
developers finding and coordinating accessibility efforts, and also for teaching devel-
opers on how to implement basic accessibility guidelines into their work or using
gamification themselves. As such, we will focus on action space representations,
reward and progress.
Congrats for reading this far! You gain 100 points!
Acknowledgments. The research leading to these results has received funding from the
European Union Seventh Framework Programme (FP7/2007-2011) under grant agreement n°
610510, Prosperity4All (“Ecosystem infrastructure for smart and personalised inclusion and
PROSPERITY for ALL stakeholders”). This publication reflects only the authors’ views and the
European Union is not liable for any use that may be made of the information contained herein.
References
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ICT Use and Acceptance
Evaluating All-Inclusive ICT with Developers,
End Users and Stakeholders
Eleni Chalkia1(&), Evangelos Bekiaris1, and R. Ignacio Madrid2

1
Hellenic Institute of Transport, Center for Research and Technology Hellas,
57100 Thessaloniki, Greece
{hchalkia,abek}@certh.gr
2
Accessibility, Studies and R&D, ILUNION Consultoría, C/Albacete 3, 28027
Madrid, Spain
[email protected]
Abstract. ICT have been moving rapidly into people’s lives nowadays. Even if
living without access to ICT would be a barrier in the past, today access to ICT
is required for most education, employment, and commerce, and is increasingly
required for travel, health, safety, daily living and participation in most of our
society. In this paper we present the evaluation of an all-inclusive ICT infra-
structure from the perspective of different type of users that use it for different
purposes based on their abilities, needs and preferences.
Keywords: Evaluation All inclusive ICT Accessibility People with dis-

abilities Developers Stakeholders
1 Introduction
Over 2 billion people worldwide have different types, degrees, or combinations of

disability, literacy, digital literacy or aging related barriers that impede or prevent them
from using ICT [1]. Society cannot afford to have this cumulatively large percentage of
people offline, yet there is no way to reach them with the current model. Thus
all-inclusive ICT that can be used from all different users is an urgent need.
To address this need, a new model is under preparation, and is called Global Public
Inclusive Infrastructure (GPII) [1]. GPII is an infrastructure that will be able to support
the usage of ICT by all, including end users, developers and stakeholders. GPII is an
umbrella under which many different projects are running to compile its vision. In this
paper we will focus on the evaluation of the all-inclusive ICT infrastructure GPII is
building in Cloud4all EU project [3].
Cloud4all focuses on creating instant and ubiquitous auto-personalization of
interfaces and materials based on user needs and preferences (N&Ps), so as to deliver
accessibility to every individual where they need it, when they need it and in a way that
matches their unique requirements.

DOI: 10.1007/978-3-319-20892-3_16
158 E. Chalkia et al.
2 Methodology
2.1 Cloud4all Methodology at a Glance
Cloud4all evaluates its all-inclusive ICT using the user centered design (UCD) approach
of ISO 13407, with continuative evaluation phases, where users test specific Cloud4all
prototypes. The results of the tests return to the developers who use them in order to
evolve their tools/solutions. Then, the updated tools/solutions are tested again and the
results return to the developers, and so on. This loop targets on creating tools/solutions
that fit the needs of their user, whoever these are; end-users, developers or stakeholders.
The evaluation of Cloud4all is realized in three iterative phases. Each iteration
phase has different objectives which depend upon the tools’ functionalities, available at
the time of the iteration, as well as, the general needs of the project. In addition, in
some cases, tools that have been tested at one phase may be tested also at the next
phase/s, since additional functionalities will be added to them or the objective of the
evaluation phase may vary and new conclusions (additional to the ones of the previous
phase) may derive for the respective tools.
In each evaluation phase, the scope of the testing has been based on assessing the
usability and the user experience of the whole system, as well as its components
separately. In each evaluation phase though, the way which the features will be used
and tested is going to be different, depending on the maturity of the different com-
ponents that participate in the developed scenarios. Thus, across the iterative phases,
different solutions will be tested with users (end-users, developer, stakeholders) in
different scenarios, at different level of maturity (Mock-up, LoFi, MeFi and HiFi
prototypes). Thus, complexity and diversity of the tested tools/solutions will charac-
terize all steps of the development work and this will be reflected in the evaluation
framework.
2.2 Methodology for Piloting the Evaluation

Piloting the evaluation testing gives research programs an opportunity to make revi-
sions to instruments and data collection procedures to ensure that appropriate questions
are asked, the correct data will be collected and the data collection methods will work
[6]. Additionally, this has the potential to help researchers identify ways to improve
how an instrument is administered. For example, if participants show fatigue while
interacting with the solutions, then the researcher should look for ways to shorten the
solution or change the device, or even the experimental planning. If respondents are
confused about how to perform a task, then the solution needs to clarify the possible
interaction and simplify this process.
Thus, in Cloud4all, in all 3 evaluation phases, the testing involves conducting a
preliminary test of data collection tools and procedures to identify and eliminate prob-
lems, allowing researchers to make corrective changes or adjustments before actually
collecting data from the target population. In Cloud4all pilot tests, 15 participants are
asked to go through the whole study, so that we can learn about the process and correct
any problems [3].
Evaluating All-Inclusive ICT 159
A typical pilot test involves administering instruments to a small group of indi-

viduals that has similar characteristics to the target population, and in a manner that
simulates how data will be collected when the instruments are administered to the
target population.
3 Evaluation with End Users

3.1 Problem Statement
There are a number of key problems affecting the access of certain user groups to
assistive technologies and specialised accessibility features that are being addressed by
the Global Public Inclusive Infrastructure (GPII) [7]. Cloud4all works directly in two of
these problems:
1. Solutions are too complicated, being difficult to find, set up and adjust, especially
when the systems should be used by different users.
2. Solutions don’t work across all of the devices and platforms that users encounter in
education, employment, travel, and daily life.
Thus, the evaluation of Cloud4all focuses on assessing the greater picture of Cloud4all
and trying to evaluate the whole procedure of Cloud4all system and the
auto-configuration of preferences. The aim is to find weak points to fix before the
finalization of the project, as well as to define issues for future developments in order to
create a seamless and flawless interaction process for the user.
Thus, the problem statement for which Cloud4all is providing a solution could be
summarized in the following scenario:
“A user is trying to use a device that is not configured based on their Needs and Preferences.
Then the user is trying to use a device which is configured based on their Needs and Prefer-
ences. The user cannot use the device which is not configured based on their Needs and
Preferences, but they can use the device which is already configured before, based on their
Needs and Preferences.
The user cannot configure the device to fit their Needs and Preferences, either because they
cannot (due to their disability) or because he/she does not know how to. It would be easier for
the user if there was an automatic mechanism, which he/she could understand, with which they
could easily login to the device they want to use and it would be automatically configured. It
would also be easier for the user if there was a tool that would allow them to create an account
and set their own Needs and Preferences than visiting the settings of each solution they want to
use and tweak them manually.
Users with disabilities are pledged to the environment in which they use the different
solutions/devices. The users cannot use the devices they want under specific contexts.
A mechanism that would allow the solution/device to automatically change based on the user’s
Needs and Preferences would enhance the user’s interaction.”
Thus the users’ problem is twofold. On the one hand they cannot use solutions that are
not configured based on their needs and preferences and on the other hand most of the
users cannot configure these solutions at all, either because they are not aware of their
needs and preferences or because they are not aware how to change the solution
settings to match them.
3.2 Evaluation with End Users Objectives

Each of the three evaluation phases of Cloud4all had different objectives based on the
maturity of the tools and the information the developers needed to extract from the
users to evolve their developments. Below, the objectives of each evaluation phase are
presented. Going through the following objectives of each iteration phase, the
evolvement of Cloud4all evaluation tests is conspicuous.
• 1st evaluation phase of Cloud4all
– Introducing the concept of Cloud4all to users and getting their general reaction
and early input.
– Presenting the ability of the basic infrastructure to automatically launch and set
up access solutions for users according to their preferences.
– Realizing very early preliminary testing of matchmaker technologies for prod-
ucts that the user has not specified any preferences yet, in Windows and in Linux
environment.
– Compare the results of the rule-based matchmaker with the results of the sta-
tistical matchmaker. The matchmakers are the features that provide the intelli-
gence of the Cloud4all system, by matching with each other all the different
components that participate in the procedure.
– Compare the results of the rule-based matchmaker and the results of the statistic
matchmaker with experts.
• 2nd evaluation phase of Cloud4all
– Identify how Cloud4all will foster digital inclusion by improving user experi-
ence, in comparison to the current way of performing a common task in dif-
ferent, familiar or not, non-personalized solutions.
• 3rd evaluation phase of Cloud4all
– Evaluate the user experience with the Cloud4all auto-configuration procedure.
– Evaluate the improved use of different devices and solutions.
– Evaluate the acceptance of the context-related changes functionality.
– Evaluate the management of Needs and Preferences with the PMT.
3.3 Evaluation with End Users Scenarios

As the objectives of each evaluation phase evolve, the scenarios the users test are
evolving too. Thus in the 1st evaluation phase a guided scenario was realized by the
users where they had to set their preferences using a simplified tool. The preferences
were captured in the form of application specific settings, which means that the
facilitator noted the value that each specific setting of the specific application under
evaluation had, after explaining it to the user and defining the effect of this setting to the
entire solution interface. The scenario was that the user would identify his/her pref-
erences first in Windows and then go to Linux and evaluate how the settings were
inferred in that OS. Then the user would have to do the procedure vice versa, identify
the preferences in Linux and then go to Windows and evaluate how the settings were
inferred in that OS. Thus we had two different set of settings to compare. One set of
settings the user defined in Windows (Token A) and compare them with the inferred
settings from Linux to Windows (Log A). And a second set of settings the user defined
in Linux (Token B) and compare them with the inferred settings from Windows to
Linux (Log B). The aforementioned procedure is depicted at the figure that
follows (Fig. 1).
Fig. 1. Cloud4all 1st evaluation phase. Auto-configuration scenario
Moving forward in the second evaluation phase, the developments evolved and so
did the procedure. The users no longer used application specific settings to define their
N&Ps, but used the Cloud4all Preferences Management Tool (PMT), which uses
common terms. Common terms are terms that harmonize the application specific set-
tings and values throughout all the applications used in Cloud4all. Thus, the users now
had a more user friendly tool to use in order to define and explore their N&Ps which
were now captured in the needs and preferences server and retrieved from there.
Additionally the users in the 2nd evaluation phase had the possibility to navigated
between different devices and not only Window and Linux. Thus, android OS, Java
mobile phones and other Cloud4all applications were made available to them. The
procedure, which is depicted in the following figure, asks the user to use the PMT in
Platform A to define their N&Ps and create a token and use this token to login to
Platform B and evaluate the inferred settings (Fig. 2).
Finally at the 3rd evaluation phase, which is the last evaluation phase, more natu-
ralistic scenarios will be evaluated. The users will be given a set of devices and
applications and also a token which will be set by the pilot facilitator based on their
disability profile. The users will be asked to navigate to these different devices and
applications as if they were in their own environment and validate the auto-configuration
procedure and results. The applications used will be close to ones the users use in their
everyday life, including TV, laptop, desktop, tablet, ticket vending machine and the
evaluation will be realized in controlled, close to reality environments like domotic labs
or user own environments.
Fig. 2. Cloud4all 2nd evaluation phase. Auto-configuration scenario
4 Evaluation with Developers

Apart from the tools for the end users, Cloud4all also develops tools to be used by
different types of developers who may benefit from the use of Cloud4all. These
developers are mainly AT developers who can add additional accessibility features to
their solutions only by incorporating them in Cloud4all and GPII framework.
One of the main objectives of GPII is “to provide the tools and infrastructure
needed to allow diverse developers and vendors to create new solutions for these
different users and platforms and to easily and cost effectively move them to market and
to users internationally” [7].
The Cloud4all project has been trying to assist the developers throughout the whole
process of integrating their solution to Cloud4all/GPII infrastructure. The greatest
existing problem is that there is no automatic way for the developers to include their
settings to the Cloud4all/GPII unified listing that has been created in Cloud4all.
4.2 Evaluation with Developers Objectives

Cloud4all provides various channels that can be used by developers in order to work
with Cloud4all and GPII. A key solution for developers provided by the Cloud4all
project, which was ready from very early stages of the project, is the Semantic
Alignment Tool (SAT), a software module for the syntactic and semantic analysis of
solutions, by taking into account the different adaptation dimensions of the offered
Cloud applications, services and tools.
An early prototype of the SAT was tested during the 1st iteration, showing that its
usability was below the project expectations and that additional efforts should be
allocated for its improvement. Therefore one of the objectives of evaluation during the
2nd evaluation phase was to test that the usability of the solution has been improved,
fostering the acceptance of the Cloud4all concept and GPII framework by developers.
The results of the 2nd evaluation phase appeared to be quite positive for the SAT,
thus in the final evaluation phase the objectives have been broadened and the objective
of the evaluation is more high level, assessing all the material that has been created for
developers within Cloud4all including the developers’ kit which encompasses the
following:
• Guidelines about the installation of Cloud4all.
• Guidelines about testing the Cloud4all/GPII architecture.
• Guidelines about the integration of a new solution to Cloud4all/GPII
– When the solution runs on a specific platform.
– When the solution is web-based.
• Additional information like
– GPII source code
– Blog for the developers
– Cloud4all wiki
– Cloud4all/GPII issue tracker.
5 Evaluation with Stakeholders

The Stakeholders’ profiles in Clou4all range from governments to service providers,
caregivers or end users’ experts, encompassing financing organizations, AT ICT
industry organizations, technology oriented organizations, governmental and legal
organizations, service providers and end-users organizations. This heterogeneous group
has different points of view and face different problems when dealing with ICT
accessibility delivery.
The main problem with the various stakeholders groups is that most of the time
even if they are totally aware of the needs and preferences of individuals with dis-
abilities, they are not aware on how to accommodate them. Stakeholder involvement in
Cloud4all has allowed us to gather ample material and knowledge about user needs and
preferences, as well as to pinpoint some challenges that we face throughout the life-
cycle of the project, such as the need to make simpler configuration processes and/or to
make users aware of the built-in accessibility features of different products and services.
5.2 Evaluation with Stakeholders – Objectives and Plan

Since the stakeholders group in Cloud4all is such a broad one the need of the iden-
tification of the needs of each subgroup was revealed early in the project. In each step
of the evaluation different subgroups have been participating providing different, but in
a lot of cases similar results.
At the first evaluation iteration only end-users organizations participated. Partici-
pants with different profiles of disability have been involved in the evaluation; how-
ever, as the end-users provided a personal view of their problems and preferences, it
was important to involve also expert representatives from end-users organizations in
order to gather as well a wider overview and experience over the needs and preferences
of the different groups of disabilities. To that end, expert representatives from orga-
nizations of elderly people, visual impaired users, people with learning difficulties and
cognitive impairments, low literacy and people with dyslexia formed the panel of
stakeholders in the 1st evaluation iteration of Cloud4all.
As the project evolved in the 2nd evaluation phase, stakeholders with different
profiles (governments, service providers, caregivers, end users’ experts) have been
involved in qualitative data gathering, to complement the end users’ and developers’
evaluations.
The goal of the stakeholders’ participation in the 2nd evaluation phase was to gather
their impressions and qualitative feedback on the concepts, tools and the whole
Cloud4all process from a different perspective. Therefore, the evaluation with the
different stakeholders was explorative and not guided by a specific research question.
This has been achieved mainly by the participation of stakeholders in structured focus
groups organized around concrete research topics like the Cloud4all/GPII concept and
auto-configuration scenario, the context-related changes scenario, the optimum N&P
gathering scenario, the GPII marketplace and recommendation system scenario, etc.
Finally, during the 3rd evaluation phase a more focused feedback is needed from the
stakeholders. For this reason, stakeholders participating in this evaluation sessions will
be selected among experts related with end user organizations as well as AT providers
and caregivers. Stakeholders with a more industrial vision, such as ICT vendors and
software industry, policy makers, etc. will be involved in Cloud4all through the Open
Days that will be planed and realized later on in the project, where Cloud4all will be
demonstrated and existing applications and tools may be experienced.
Thus, the goal of the stakeholders’ evaluation in the 3rd evaluation iteration is to
gather their impressions and qualitative feedback on the concepts, tools and the whole
Cloud4all process (including installation) from two different perspectives:
• Which is the usefulness for users? (from stakeholders’ point of view), and
• Which is the usefulness for stakeholders? (Being the stakeholders as mediators/
supporters of end-users organizations or AT providers).
Stakeholders will be involved in structured focus groups where the whole Cloud4all
concept (from installation to use on different devices) will be presented. Based on this,
stakeholders will participate on discussions around the following concrete research
topics.
6 Conclusions
In this paper, we presented the evaluation framework developed for all 3 evaluation
iterations of all-inclusive ICT with end users, developers and stakeholders in the scope
of Cloud4all/GPII. Each user group has been treated as a different part of the evalu-
ation, being all though under the general umbrella of the evaluation and evolvement of
the all-inclusive ICT infrastructure of Cloud4all and GPII.
In each evaluation phase different objectives and research questions have been
sketched in order to serve the needs of the project in each stage. These have been
evaluated using different scenarios for each user group and for each evaluation iteration
going from more simplistic to more mature and complex ones.
Starting from the 1st evaluation iteration where the participants had in their hands
mainly mock-ups and only some low fidelity (Lo-Fi) prototypes and were able to assess
only basic functionalities of restricted Cloud4all tools being fully guided from the
facilitators, we moved to the 2nd evaluation iteration where the participants had a full
range of medium fidelity (Me-Fi) Cloud4all functional prototypes and were able to go
through the whole Cloud4all experience from setting their own preferences to viewing
who these preferences are inferred to a specific set of devices. And finally being on the
3rd iteration where the users can transfer their set of needs and preferences throughout a
vast number of solutions in a very close to reality, unguided scenario and environment.
Acknowledgements. This research was funded by the European Union’s Seventh Framework
Programme (FP7/2007-2013) grant agreement n° 289016, by the National Institute on Disability
and Rehabilitation Research, US Dept of Education under Grant H133E130028 (UIITA-RERC),
the Ontario Ministry of Research and Innovation, and the Canadian Foundation for Innovation.
The opinions and results herein are those of the authors and not necessarily those of the funding
agencies environment.
References
1. Prosperity4all project. http://www.prosperity4all.eu/
2. Global Public Inclusive Infrastructure (GPII). http://gpii.net/
3. Cloud4all EU project. http://www.cloud4all.info/
4. Dix, A., Finlay, J., Abowd, G., Beale, R.: Human-Computer Interaction. Prentice Hall,
New York (1997)
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6. Tullis, T., Albert, W.: Measuring the User Experience: Collecting, Analyzing and Presenting
Usability Metrics. Morgan Kaufmann Publishers, Inc., San Francisco (2008)
7. Vanderheiden, G.C., Treviranus, J., Markus, K., Clarck, C., Basman, A.: The Global Public
Inclusive Infrastructure Cloud4all and Prosperity4all. In: Encarnação, P., Azevedo, L.,
Gelderblom, G.J., Newell, A., Mathiassen, N.-E. (eds.) Assistive Technology: From Research
to Practice. IOS press, Amsterdam (2013)
Access and Use of ICTs Among the Italian
Young Elderly: A Field Study
Fausto Colombo and Simone Carlo(&)
Università Cattolica del Sacro Cuore, Largo Gemelli, 1, 20121, Milan, Italy
{fausto.colombo,simone.carlo}@unicatt.it
Abstract. Our research aims to investigate the relationship between the young
elderly (65–74 years old) and use of technologies [1], and to explore active
ageing and the role played by media and ICTs in building a friendly and pos-
itively domestic environment for the elderly in their everyday life [2]. Hence the
use of ICTs by the elderly takes into account two different perspectives:
(1) Generational approach: the young elderly are here considered by looking at
the role played by their generational identity in shaping their media use [3].
(2) Domestication and Leisure: Media consumption is spatially and temporally
located and media uses and routines are shared within the household and are
enabled by processes of domestication [4]. The project is based on an theoretical
study about ageing, a preliminary survey with a representative sample of the
Italian “young elderlies” regarding ICTs equipment and usage (N = 900), (3) 20
family in-depth interviews in Milan area.
Keywords: Elderly ICTs Active ageing Domestication Generations
1 Introduction
The role of media and communication technologies in helping the quality of life, health
[5] and care [6] of the elderly is today a key issue in the academic and political debate.
Studies have been mainly focused on the use of the ICTs as tools replacing physical or
cognitive deficits of the elderly [7]. Political institutions have regarded digital tech-
nologies as a way to avoid a new kind of divide among the elderly of today and
tomorrow, hence promoting policies designed to build technological literacy among
them elderly. These policies are often utopian and deterministic. The ICTs would allow
the elderly to solve some problems related to their age such as disability, loss of mental
faculties, diseases and loneliness.
If it is true that ICTs are a useful resource for the elderly to improve their health,
their care and their social life [1], it is equally true that they are used by the elderly for
their entertainment [8]. The usefulness of ICTs is accompanied and often is exceeded
by their role as pastime, in a stage of life with a lot of spare time.
Taking into account these assumptions, a quantitative and qualitative study was
conducted with the aim to understand social contexts, positive and negative attitudes
related to the use of ICTs in the daily life of the elderly.
This study aimed to question the possible benefits and risks related to the use of new
technologies for the elderly users, by taking into account the issue of domestication of

DOI: 10.1007/978-3-319-20892-3_17
Access and Use of ICTs Among the Italian Young Elderly 167
the ICTs in today complex social context [18], and by considering the third age as part of
a particular generation. The paper here presented shows the main results of this research
and is structured as follows: in the next section the research background and the the-
oretical approach used will be discussed; in the following sections the results of the
study will be presented; and finally some implications for the potential orientation of
policy-making will be formulated.
2 Context, Theoretical Framework and Research

Methodology
2.1 National and European Context
The over 65 years elderly people are in Italy generally less online comparing to the
average European population. There are significant developments but the Italian
population is less digitized than the European one: with 16.3 % of Italian young elderly
users (65–74 years old) comparing to the European average which sees 34.4 % of
regular Internet users in the same age group (Source: European Commission).
Digital media are used by a very small niche of young Italian elderly [3]. 21.3 % of
the Italian elderly own or use a computer: only 17.5 % a laptop and only 16.7 % a
desktop computer. Data become more relevant if related to specific age groups (dis-
tinguishing between two age groups: 65–69 and 70–74) and gender.
Moreover 45 % of the young elderly using the computers today started using it
before being 50 years old, 28.2 % between 50 and 59 years, 19.1 % between 60 and 64
years old. Only 9.1 % of users are “new” ICTs users (starting to use the computer after
the age of 64), with a significant difference between males and females: respectively
with 6.8 % of men compared to 12.8 % of women. When looking at the spaces of the
ICTs, home is regarded as the best place for Internet access, with 98.8 % of domestic
connections and, in second place, 15.3 % of connections at work (among our sample
with Internet access). The young elderly access to the Internet alone. However there is a
significant amount of young elderly users accessing with the partner (19.2 %), with
their children (17.6 %), with their grandchildren (4.7 %). As regards the frequency of
use: 71 % of the young elderly accessing the Internet do so almost every day. Moreover
58.8 % of the young elderly argue that they access to the Internet any time of the day,
when it is probably useful to do so.
2.2 The Digital Elderly: Beyond a Biological Approach

The biological age seems to represent, for many theoretical approaches, a key element
to explain the aforementioned gaps and to determine the use of ICTs by the young
elderly [9]. Biological age is regarded as a such crucial element in making the elderly
“laggards” digital users by definition when compared to younger subjects [5].
This point has led to the birth of a series of comparative analyses between young
and old Internet users, taking into account the theoretical metaphor by Prensky [10]
between digital immigrants and digital natives. This metaphor has strongly influenced
the following academic debate, coming to describe the increasingly digital world as a
168 F. Colombo and S. Carlo
world naturally more suitable for young people than the elderly. As regards to use of
the ICTs, this approach has also often pointed out how young people use the ICTs for
the leisure time, and conversely adults, in their general strangeness to the digital world,
use ICTs only in few limited occasions and for specific tasks.
To overcome this limiting approach focused upon biological age, two theoretical
perspectives are here considered: one is the generational theory, the other the theory of
domestication [4, 18] and the importance given to the household as a (physical and
symbolic) space to use technology in everyday life of the elderly [2]:
• Generational Approach and (Digital)Media Consumption: The generation of the
young elders of the here presented research is enjoying the benefits of a progressive
lengthening of life expectancy: this lengthening has created a new third age, which
is distinct from the fourth, characterized by double emancipation from the family
and work constraints [11] with a considerable amount of free time [12], money and
status [13]. The adoption and use of ICTs fit in stories/biographies of the older
generations [14], in their spare time and economic resources hence influencing their
media consumption [15, 16];
• Leisure, Domestication, Everyday Life: The theoretical approach of domestication
[4, 17] seems extremely helpful to take into account both the growing importance of
digital media in the (spatial and temporal) contexts of the young elderly and the
relationship between symbolic consumption and consumption of devices [18].
As regards to a “new generation” of digital users, domestication can be a very useful
model to understand the ways in which the young elderly get used to digital media and
to the use of new devices in their everyday lives, but also the role played by social and
family networks in the process of incorporation to the ICTs [19].
In particular, daily family relations (with grandchildren, children, peers) are a key
element in the dynamics of adoption of the ICTs in general and in the definition of a
media consumption that is daily organized [20].
2.3 Objectives and Methodology

The main research objective was to understand the role played by the ICTs in the daily
life of the elderly and the spatial and temporal organization of their lives. A crucial
importance was given to the role played by the intergenerational relations in shaping
media use and learning style of the elderly.
The research wanted even to investigate the possible relationships in place between
the elderly and young people, with the aim of understanding the dynamics of inter-
generational exchange, family use and domestication of ICTs [21].
The research project is based on a survey conducted between December 2013 and
January 2014 through a face-to-face questionnaire administered to a statistically rep-
resentative national sample of 900 young elderly Italians aged between 65 and 74 years
of age (selected according to a random, proportional, stratified division defined by
region and by the size of the place of residence, divided into two sampling stages).
Taking into account the preliminary results of the questionnaire, in May of 2014, 20
in-depth and unstructured interviews to young elderly aged between 65 and 74 years
old and ICTs users were conducted. Interviewees was selected according to age
(divided in two subsamples: 65–69 and 70–74 years old), household composition (with
or without cohabitants) and geographical location (large or small city in Milan area).
3 The Young Elderly and the Adoption of Digital Media
In the following pages some of the main results of ethnography will be discussed,
postponing the release of the in-depth survey analysis for other publications [13].
Starting from a grassroots approach, we describe here the main results using 4 cate-
gories that help us to frame the role of ICTs in biography, everyday life and domestic
contexts of elderly.
3.1 Use of the ICTs and (Spare) Time

Use of the ICTs by the respondents is strongly influenced by their employment status:
almost all of interviewees are not working (as retirees or housewives). This condition
allows them to have a considerable amount (but variable from subject to subject) of
non-working time which is managed differently among them:
• For some respondents, non-working time is regarded as “free” time: these
respondents (i.e. housewives or those being retired from a long time) have now a
consolidated management of their spare time. For these people, the time off from
work - that exceeds the time spent on activities such as sleeping, bathing, dressing,
cooking, tidying the house, grocery shopping and so forth - it is now an central part
of their daily routine. For these subjects, their timing seems to be more standard-
ized, more stable, less problematized, more time-spending.
• For other respondents, those being retired more recently, the perception of free time
is mostly understood as a new time to spend off from work: these people perceive
more than others the sharp divide between “before” (“when they used to work”) and
“after” (“now that they are not working anymore”). For some people this changing
situation is handled in a problematic way: the time freed from work is considered a
time of “forced laziness” for the loss of any productive role. These people are
therefore living with the urgent need of making their time useful, meaningful,
creative and productive rather than time-spending. Spare time therefore, conceived
as time off from work, is likely to be considered as an empty time, and as a
significant time for all older people, but especially for recent retirees who consider
this time strongly linked their new life and identity as retirees. In this context, the
use of ICTs is strongly influenced by the spare time of these respondents and is part
of their effort to “shape” and/or “give value” to their time: the value given to (digital
and otherwise) media consumption is strongly connected to the value given to their
spare time.
3.2 Biography of Appropriation

Apart from any specific individual and personal story, three major trends or bio-
graphical paths of appropriation and incorporation can be identified. Contexts, family
stories of the respondents strongly influence their expectations, motivations, anxieties
and enthusiasm over the use of the ICTs.
(a) New Digital Elderly in an Old Digital Home. These are the young elderly who even
though having never used the ICTs, they had at home computers and laptops of their
children, but they have approached recently the world of the ICTs. These young
elders decided to approach the ICTs once being retirees, hence once having a lot of
free time. For these people, family relations (children, partly the partner and
grandchildren) play a crucial role in their approach to the digital world. Processes of
intergenerational learning are here in place. As regards their skills these people have
recently had to learn to write with a keyboard and to use the mouse. Learning process
takes place through a constant and everyday use: the use of the computer is perceived
as a tiring but rewarding “commitment”, which makes their time significant.
(b) New Digital Elderly in a new Digital Home. These are the elderly who have never
used the ICTs, have bought recently the first computer of their household and have
started using them only late in life, as part of leisure activities. These people are
usually housewives, workers, those retired from late ‘80s, mid-90s, who have never
used the computer at work. In some cases, these individuals had careers in man-
agement and business and did not need to know how to use the computer, the use of
which was intended to more operational roles. They are generally people without
children, or with children who have never owned and used a computer. Therefore
they recently own a computer and if not very recent, when the children were already
out from home. These respondents decided to have and use a computer not a any
specific need but because they wanted to keep themselves update.
(c) The Digital Experienced Elderly. These are the young elderly who already used the
ICTs at work since the 90s and have continued to do so even after the retirement.
These people worked until the early 2000s and fully experienced the digitization of
administrative procedures occurred in the late ‘80s and ‘90s with word processing,
data entry, office suite, accounting and management software. Since the early ‘90s,
thanks to the lowering costs of PCs these young elderly had a PC at home and
decided to deepen their skills in the use of PCs and the Internet within the
household. PC is not the only digital device for the household: some PCs (IBM
compatible with Windows operating systems) have replaced or have been joined to
the previous computers provided for the children (Commodore 64), however, used
only for entertainment. Owning and using the computer was a largely established
and domesticated practices in the family history of these respondents. PCs became
available to the whole family and used by both parents (often solely and exclusively
by the already digitized parents in charge of the buying decision) and by their
children. At this early stage, parents were teaching the use of computer and the
Internet, because of educational needs of their children (in the ‘90s some of them
were students). As regards the issue of digital literacy, these young elders prove to
have a strong independence. Users show advanced computer skills, developed over
years of daily computer use. To summarize, for these subjects the domestication of
the computer is rooted in a long family history. The retirement has radically
changed computer use from being useful to being entertaining.
3.3 Spaces of the ICTs

The analysis of the spatial arrangement of the ICTs makes clear the processes of
acquisition, the biographies of use, the history of the adoption of technologies, but also
the moral economies, routines, methods of use of the technologies.
As regards this issue, a great difference can be found between those buying PCs
only in recent times and those owning and using computers from a long time.
• The first type of young elderly recently buying a computer at home usually do not
have a room for the PC and have adapted the space of the house to make room for
the computer. That is why that these people (most of the respondents) usually have
laptops with some of them having or not a fixed workstation. Those not having a
fixed workstation do not necessarily have a less intense use of the computer of those
having a fixed workstation. In some cases, the arrangement of the workstation
(laptop, mouse, printer) is a daily routine, a sort of “ritual” to start to use the
computer. The main difference between those households having workstation and
those without concerns the sharing of skills: the arrangement of the station is a
further barrier to the use of the ICTs for a couple who is in need of help at the
beginning. In many cases, the organization of the space for the computer thus
becomes an additional element in the gap and difficulty of access for some less
digitized subjects. Moreover, in some cases, the advent of the computer causes
tension between the partners, with respect to the possible mess caused by the
computer, from the wires and the various devices connected to the computer (printer
and modem). In this case, the choice of the location can be a further matter of
argument in the couple, especially between digital and not digital spouses.
• The second type of family has a computer at home from a long time and has left the
computer in the same location, usually the room of their children which has been
changed into a study room. Hence this room is used primarily by one of the partners
(usually the more digitized, who has more control and availability of the computer)
and not equally by both of them, hence, in some families, increasing isolation and
separation between the couple. These couples have also usually more than a TV,
hence avoiding any possible negotiation about what to watch on TV. More than
that, the asymmetric digitization has radicalized the differences between partners:
digital knowledge and skills are not usually shared between the partners. Digital
divides hence increase between those who “know and use the ICTs” and those who
rather leave the use of the computer to the partner.
3.4 Incorporation and Timing of Use

The role given to computer and the Internet by the subjects under study has a strong
impact on the timing of use of the ICTs for the respondents.
• On the one hand, some respondents have a strongly focused use aimed at doing
something specific, at carrying on a task (i.e. at finding out, at looking at, at buying
something), and at saving time for a task which would have required more efforts
(one above all: home banking). Internet is meant to be time saving. In this case the
use of computer and the Internet takes place once needed.
• On the other hand, other respondents have a more time spending use with the
computer and the Internet being time spending. In this case the use of computer and
the Internet happens without any specific purpose and often in specific day times
(after waking up in the morning, after lunch, before dinner, before going to bed, etc.).
However many respondents tend to have a dual use, combining time spending attitudes
to more focused sessions of use. They finally have, in terms of time, a very intense use
of the computer and the Internet, spending a long time during the day at the computer
and turning on the computer as the first activity of the day.
The majority of elderly people who have access to the Internet are therefore heavy
users. The Internet is a world that is rooted in the everyday life of the sample: once
crossed the threshold of access to the ICTs the elderly become not occasional users.
For some people, browsing sessions are mostly time spending, hence transforming
the use of the ICTs that despite being typically time saving or functional in a time
spending activity (e.g.: to open new mail account without real utility, to download
many apps without using them, to enroll in many forums with no real participation in
the discussion).
The extended and excessive use of the Internet is in some cases regarded as an issue
hindering family life, previous routines, and the potential activities not carried out in
favor of the Internet use.
Respondents are therefore particularly heavy users of the computer and the Internet.
Such use, however, is not equally distributed during the day or the week. It clearly
emerges that the computer and the Internet are predominantly used during the day and
the week days, because these are the time mostly spent alone (children or partner might
be away to work) with the chance of not being disturbed. The use of the computer
during “office hours” thus seems to recreate working routines recently overcome
because of retirement.
The values attributed to the time of use of the ICTs is also affected by biographies
of appropriation:
(a) New Digital Elderly in an Old Digital Home. For these subjects, to be in the digital
world means also to have the chance to get in touch with their children, relatives and
friends and to an already digitized networks of relationships. Activities, such as
spending time learning to use the Internet and the computer, asking for help to their
children or relatives, but also online chatting or emailing, are considered rewarding
because they strengthen and increase the relations among their family network.
Being offline would also mean to lose these relational opportunities: their digital
literacy encompasses a continuous exchange of information with their children or
relatives already on Internet. For the respondents, the (long) time spent at the
computer, with the goal of learning something radically new, it is perceived as well
spent time because it enables them to be constantly connected to their social network.
(b) New Digital Elderly in a New Digital Home. For these subjects, the very recent use
of the computer and the Internet makes them feel “active” to learn and to explore a
new digital world and fits firmly in everyday life and in their time off from work.
The use of the computer is often part of other time spending activities, as a new and
exciting hobby. They are not necessarily fans of technology, but they rather see in
learning something “new” a way to overcome a repetitive routine. The computer
becomes for these subjects a key element to enrich their everyday life and to give
value and meaning to too much free time.
(c) The Digital Experienced Elderly. For the digital experienced elderly, the use of the
computer was meant to be, once they were still working, limited to certain times of
the day (in the evening after work, after dinner and on weekends) and task-oriented.
In recent years, because of retirement, something have changed in their timing of
use from being task-oriented to being very time spending and entertaining.
Those who retired recently feel the time they spent at the computer as a time off
from work, as a free time to fill up: for these digital elderly the ICTs are perceived to be
essential but mostly entertaining and as filling their time, which is perceived (because
of the retirement) too much.
Moreover it generally emerges a loss of time spent watching TV in favor of surfing
the Internet. However this replacement is limited to specific times of the day, mainly
morning and afternoon, when television programming is perceived to be low quality.
From this point of view, surfing the Internet during the morning or afternoon seems
to be a viable alternative, being more involving, interesting and entertaining than
watching TV. It is also interesting to notice that watching TV can be more frustrating
than surfing the Internet, as if watching TV as a time spending activity is likely to be less
appreciated that wasting time surfing the Internet. If the young elderly seem to watch
less TV in the morning and afternoon, during the prime time, television seems to still be
central in the media diet of the young elders: on the one hand because they have
established routines with certain TV programs, on the other hand watching TV is still
considered a family moment, and despite the passing years, it is still perceived as crucial.
4 Conclusions: ICTs, Domestication and Risks
The here presented study has aimed to investigate the role played by the ICTs in the
daily life of the young elderly. These first research results allow us to draw some
conclusions and make some inferences.
Our research show that (1) ICTs and the Internet have a significant impact on young
elderly everyday life and their spatial - temporal domestic routines; (2) processes of
ICTs domestication are basically influenced by personal and generational biography of
the young elderly (previous job, intra- and inter-generational relationship, familiar
contexts) and not only by age or other socio-demographic characteristics (gender,
income, education) (3) ICTs and the Internet seem to be a good opportunity for a better
and active ageing (e.g. in terms of improvement of social relations, information,
entertainment), but even a risk in terms of social isolation inside and outside family.
1. First, the age group under research (65–74 years old) is characterized by an high
percentage of non-workers (housewives and retirees) [22]. These people have a
significant amount of free time, off from work that they mainly spend at home [23]
where practices of media consumption and processes of adoption of new technol-
ogies take place. Media consumption involves processes of domestication and
routines which are shared within the household and the family. The use of the ICTs
is mostly happening in the household, with a significant resistance to mobile use.
Second, although a relatively low ICTs diffusion among the elderly is confirmed by
the study, it clearly emerges a trend among the young-older users: the ICTs are
central for their daily lives and for their time at home. For the minority of those who
are digitized, the ICTs have a major impact in shaping their free time (quite sig-
nificant in terms of amount): Internet is used by elderly basically for entertainment
and leisure as a time spending activity.
2. It significantly emerges that the biographies of adoption allows us to understand the
different approaches to the ICTs: beyond the biological age, the personal, working,
family, generational dimensions influence the paths of domestication to technology.
The retirement, the relationships with family members, but also the spatial orga-
nization of the household, are all elements strongly influencing access and use of
the ICTs, confirming the usefulness of domestication approach to understand these
phenomena. In particular, our study shows that the domestication of the ICTs (as
objects and symbols) is a slow process that has its roots in the history of the young
elderly as digital “users”, able to (more or less enthusiastically) domesticate pre-
vious technologies (televisions, video games consoles, computers, digital TVs,
mobile phones, etc.). The domestication allows us to understand the adoption of
technology by the elderly as an evolutionary process, as an everyday social prac-
tice, as the outcome of a biography of media consumption enabled by domestica-
tions and re-domestications to technologies as an outcome of processes of
remediation [24]. As regards the generation, the category of multi-dimensional
generation appears to be particularly useful to study the elderly, who are hardly
describable by looking at their socio-demographic traits (age, gender, education,
employment position) but rather at several elements - as social position, social
contexts and changes that these contexts have had over the years and relationships,
shared values with their own generation, biographies of media consumption, and
social networks. All these elements work as environment to the experience of media
consumption. The present young elders – first of all - belong to a specific gener-
ation: the Baby Boomers generation. The study shows how this generation is related
to learning process developed since the 90s (intra-generational dimension) thanks to
the digitization of their job and workplace, and learning mediated by children and
grandchildren (intergenerational dimension). The subjects under study belong to a
generation that experienced, primarily in the workplace, the birth of computer
science and that had the chance to learn and get updated by the younger and
strongly digitized generations. The today 65–74 years old Italians seem to belong to
a “in the middle” generation with several features depending on their past (of partly
digitized workers) and present (healthy, wealthy and generally with a lot of free
time retirees): in the future, with the gradual spread of digital skills, with the
increase in the retirement age, with changes in the welfare system, those aged 65–74
years old will probably have other practices of domestication and use of the ICTs,
associated with a reasonable different time management between work and leisure,
different family relationships, and a likely different level of wealth and health.
3. Finally the dual role of the ICTs in daily life of the young elderly is the last issue of
interest. Literature and research around the use of the ICTs among young people has
long urged the potential for (personal and social) empowerment arising from the use
of the Internet but also the risks arising from an unaware and irresponsible use of
communication technologies [25]. This focus given to the complex and dual rela-
tionship between ICTs and risks/benefits for users appears to be a marginal part of
the debate regarding silver users. ICTs are more often regarded as tools able
“deterministically” to positively impact the lives of the elderly. However it is
necessary to, especially when discussing about policies aimed to promote active
ageing, carefully consider the complex nature of media and the ICTs. For example,
it clearly appears in the research that ICTs can help the young elderly to broad their
relational network (inside and outside the family) but also to close themselves in the
household sharpening isolation between the partners. ICTs are both promoting
active ageing (enabling update, the relationships and brain activity), but also new
risks of loneliness, because in some cases the overuse (with online time-consuming
brainless activity) do not encourage the young elderly to spend their free time
outside from home and to live their relations with the partner fully.
In terms of policies, these results seem therefore to be a recommendation to develop
inclusive policies that take into account the dual role played by the ICTs: the processes
of inclusion should aim to promote active ageing and not simply the diffusion of ICTs.
In line with the recent sociological debate [25], active ageing should not be understood
solely in terms of health and lengthening of life expectancy but also as owning and
using technologies [7]. Active ageing means quality of life and being able to experience
a sense of subjectively and socially rewarding ageing: quality and gratification that also
depends on (conscious, careful, thoughtful, moderate, in relational contexts) “good
use” of the ICTs.
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Patterns of ICT Use among “Senior
Technology Experts”: The Role
of Demographic Variables, Subjective Beliefs
and Attitudes
Michael Doh(&), Laura I. Schmidt, Florian Herbolsheimer,

Mario Jokisch, and Hans-Werner Wahl
Department of Psychological Aging Research, Institute of Psychology,

Heidelberg University, Bergheimer Str. 20, 69115 Heidelberg, Germany
{michael.doh,laura.schmidt,
florian.herbolsheimer,mario.jokisch,
hans-werner.wahl}@psychologie.uni-heidelberg.de
Abstract. Information and communication technologies (ICT) play a sub-

stantial role for enhancing participation and autonomy in old age. In Germany,
as in most modern industrialized societies, huge diffusion gaps between younger
and older age groups exist regarding the use of the internet and ICT devices.
Very few studies address the differential role of older “frontrunners” in terms of
modern ICT. In this project, we address patterns of ICT use and competence
beliefs among “senior technology experts” (N = 108; aged 51–81, M = 68.37),
who took part in a German initiative to help older novice users with ICT, and
explore the associations with psychological constructs such as self-efficacy and
obsolescence. Findings suggest a strong relationship of two self-efficacy mea-
sures and perceived obsolescence with usage patterns and competence ratings.
Insights on usage patterns, perceived competence and associations with psy-
chological constructs are discussed, as they may help improve the understanding
of early technology adopters among older adults with implications for research
and practice.
Keywords: Technology Use Diffusion Self-efficacy Obsolescence Aging
1 Introduction: Ageing Societies and Mediatization
Modern societies undergo a fundamental transformation that can be characterized by

two developments: On the one hand, there is the global trend of aging populations with
a higher number of individuals reaching increasingly higher ages, and with continu-
ously decreasing numbers of younger individuals at the same time. On the other hand,
due to dynamic technological innovations and intensified diffusion of information and
communications technology (ICT), nearly all areas of modern life are increasingly
affected by media und technologies [1–3].
There is evidence that those two trends are strongly interconnected. For instance,
innovations in the field of medical technology and engineering have been playing a

DOI: 10.1007/978-3-319-20892-3_18
178 M. Doh et al.
substantial role for life expectancy, particularly among individuals in their later stages
of life. Furthermore, the societal and economic importance of older persons as con-
sumers and recipients of medial and technological devices is growing.
Following Baltes [4] these cultural-historical developments can be integrated into
his concept of an “incomplete architecture of the human ontogenesis”: With higher age
and with age-associated vulnerability and declining abilities and resources,
culture-based resources are required at increasing levels. However, because of
age-related losses in biological plasticity, the efficiency of culture is reduced in
advanced age. Gerontechnological devices and services represent an application of
these assumptions, as technology in general can be incorporated to the umbrella of
“culture”. (Mobile) information and communication technology hold the potential,
especially for older individuals, to facilitate everyday activities and foster indepen-
dence, for instance in the domains of information, communication, participation,
autonomy, mobility, education and health. But, referring to the assumption of reduced
efficiency, technological innovations also imply environmental pressure [5], and
autonomy or participation in the later years could also be impeded by devices that are
difficult to manipulate [6, 7]. This is particularly the case for older generations and
inexperienced individuals, who consider the access to the digital world itself as a major
challenge and may face various barriers related to new ICT devices.
At this point, an interaction of barriers related to the environment, to the techno-
logical device and to the person can be assumed. In Germany, for instance, learning
opportunities for older people living in rural and structurally underdeveloped regions
are scarce and, moreover, there is often a lack of fast broadband or WLAN connection
[8]. Additionally to the environmental perspective, many devices lack usability or
intuitive design and have a short half-life. Due to a highly dynamic innovation process,
acquired knowledge is rapidly becoming outdated. Further hindrances, located at the
intersection of the person and the device, may be imposed by unnecessary use of jargon
or complicated language and uncertainty regarding privacy issues. Person-related
aspects with relevance for technology ownership, use and performance include
socio-demographic variables (age, sex, education, and income), personality, health and
cognitive abilities, but also attitudes towards and experience with technology,
self-efficacy and obsolescence [9, 10].
Therefore, both society and the aging individual are challenged to make use of the
potentials of technological innovations. According to the commission of the “5th report
on ageing” of the German Federal Government lifelong learning is both a right and a
duty [11].
2 Cohort Effects in Internet Diffusion
In order to better understand the background of the current study, the German diffusion
rates regarding the internet are shortly summarized. In 2014, 79% of persons aged 14+
were using the internet, representing the largest community in Europe with 55 million
internet users. With respect to persons aged 60+, the diffusion rate is 45%, with 9
million users [12]. A decade ago in 2004, the general diffusion rate among 14+ was
55% and among 60+ 15%, and in 1998, only 10% and 1% respectively. However, this
Patterns of ICT Use among “Senior Technology Experts” 179
%
100 +35 PP
90
+45 PP
80 +51 PP
70
60
50
95 +28 PP
90 93
85
40 79 77 79
72 72
63 65
30 60 57 54
60 +13 PP
50
20 42
34 33 33 35
25 27
10 19
14 14 13 14 15
7 10 8
0 2 5 6
02 04 06 0810 12 14 02 04 06 0810 12 14 02 04 06 0810 12 14 02 04 06 0810 12 14 02 04 06 0810 12 14
14–49 Years 50–59 Years 60–69 Years 70–79 Years 80–99 Years
Source: Own analysis from the (N)Onliner-Atlas, 2002-2014 (n = 30.000 – 50.000)
Fig. 1. Internet diffusion in Germany 2002–2014
huge development reached a phase of stagnation in the last years. In a European

comparison, Germany only reaches a rank 11, far behind Iceland or Scandinavian
countries [13]. Furthermore, when comparing older age groups, large differences
emerge as well. Own analyses reveal a diffusion rate of 65% in the group of persons
aged 60–69, but only 35% among persons aged 70–79 and 15% among those aged 80–
89 years (see Fig. 1).
The growth rates in Fig. 1 are mostly due to younger internet users that are growing
into the age segment, which is supported by cohort analyses indicating relatively low or
stagnating increases in diffusion rates for those born 1949 and earlier.
Alongside age, other socio-demographic factors such as sex, education and income
are related to technology and internet use, with a cumulative effect in older ages
(sometimes labeled as “singularization” and “feminization” of old age). For instance,
among men aged 60+ with high socio-economic status living in a multi-person
household in western Germany, the internet diffusion rate is 88%. For comparison,
among women in the same age group with low socio-economic status living in a
single-person household in eastern Germany, the corresponding rate is 6%, and those
differences between groups have been found to have increased since 2002 (own
analysis based on data of the (N) Onliner-Atlas).
Rogers’ diffusion theory [14] can be drawn on to explain those differences, stating
that technological innovation are adopted first by groups with high social status,
financial liquidity, advanced education and social forwardness (“innovators” and “early
adopters”). Later on, when the larger group of “early majority” has decided to adopt a
technology and the earlier groups have reached a point of saturation, the “late majority”
180 M. Doh et al.
and especially the “laggards” – who tend to be older and more skeptical – are (slowly)
starting to catch up.
Studies are needed to better characterize those special older individuals among the
typically late adopting older age groups, as they may serve as opinion leaders that are
influential in spreading positive information about the internet and modern ICT.
3 Attitudes and Subjective Beliefs Relevant for ICT Use
Besides socio-demographic factors such as age, education or sex, psychological con-

structs in the area of attitudes, convictions, or beliefs have been found to be associated
with technology use [15–17] and performance with technology-based tasks [12, 18].
Especially self-efficacy, i.e., the belief in one’s own ability to complete tasks and reach
goals [17], seems to be related to positive evaluations of technology [20], and plays a
more substantial role in explaining involvement in new technologies than demo-
graphics [21, 22]. Furthermore, there are first indications that a construct named
“obsolescence”, defined as gradual loss of social integration and perceived lack of
competence to deal with the demands of modern society, is related to technology use
[23]: Findings indicate a mediation effect of obsolescence regarding the relationship of
technological experience and loneliness. Furthermore, persons with higher feelings of
obsolescence (for instance: “being antiquated”) revealed a higher numbers of errors and
needed more time for tasks with technologies such as a mobile phone or an eBook
reader and reported more concerns regarding usability issues [10]. Typically, feelings
of obsolescence increase with age [24].
With respect to our intention to focus on those older “frontrunners”, who belong to
the early adopting individuals within the older age groups, specific self-efficacy beliefs
are more promising than global or general attitudes towards technology in order to
explore relations with technology competence and usage patterns. As self-efficacy can
be improved by mastery or vicarious experience [19], self-efficacy might also imply a
starting point for interventions.
Furthermore, very few studies address the concept of obsolescence, which might
help to understand differences in competence and breadth of modern ICT use, even
among this special group.
4 Aim of Current Project and Research Questions
Summarizing existing research gaps, there is the need for studies addressing psycho-
logical factors, environmental-structural issues and technology specific aspects for the
adoption and successful handling of ICT in older adults, and further, a need to link
those concepts to internationally renowned theories such as Roger’s diffusion theory
[14] or Bandura’s social learning theory [19]. Therefore, our study combines media
research and behavioral gerontology approaches.
The study builds on the German initiative “Senior Technology Experts – Transfer
of ICT knowledge from older adults to older adults” launched by the German Federal
Ministry of Education and Research (BMBF). Within this initiative, 18 regional pro-
jects in ten federal states of Germany received funding in order to promote and
facilitate the use of modern ICT (i.e. tablet, smartphone, and laptop) and Ambient
Assisted Living (AAL) applications among older adults. Target groups also included
novice users with little access to technology such as persons with a migration back-
ground, women, inhabitants of rural areas, or even blind persons. The projects offered
low-threshold educational programs such as courses in small groups, information
meetings, consultations or home visits.
Project FUTA (Factors for the Use of New Information and Communication
Technologies in Old Age) has the aim to gather data on resources and barriers that
explain variance in usage patterns and perceived competence in managing mobile ICT
and AAL applications among two groups of older individuals that differ in terms of
technology experience: (a) so called “senior technology experts” and (b) novice users
with limited prior technology experience or knowledge.
As the data collection with respect to AAL and among novice users is still ongoing,
the current paper is focused on 12 projects on mobile ICT and on the group (a) of
“senior technology experts”. These older frontrunners are empowered – to some extent
even trained – to explain the use of modern ICT to novices. In this initial paper, we aim
to better understand usage patterns and associations among those senior experts, as they
are meant to serve as successful role-models for novices later on. Furthermore, we aim
to overcome the lack of differentiation with regard to psychological variables.
Research questions are as follows:
(1) How can the biographical development of ICT adoption help to better characterize
the senior technology experts?
(2) How is the relationship of specific psychological constructs (obsolescence and
two measures of self-efficacy) and breadth of ICT use and competence?
As modern ICT are increasingly becoming an integral part of daily life among older
adults, but relatively little is known about the characteristics of older “frontrunners”, we
thereby aim to contribute to this upcoming area of research. The study of those “early
adopters” might be the key to better understand the process of diffusion among older
users, as they may serve as opinion leaders and role models for non-users of the same
age-group.
5 Method
We used data from the online-questionnaire of the FUTA project that was carried out
between October 2014 and January 2015. A convenience sample was drawn from all
participants within the initiative “Senior Technology Experts”. The study collected
information on individuals’ attitudes towards new technology, media use, and social
and economic circumstances. In total, 108 participants, all representing senior tech-
nology experts who provided courses or information sessions with mobile ICT (laptop,
tablet and smartphone), completed the whole online questionnaire (mean overall time =
43.11, SD = 14.06). A prior feasibility study has estimated that over the period of the
whole initiative (October 2013 until September 2014) about 240 experts were engaged
in one of twelve projects dealing with mobile technology. That implies a response rate
of 45%.
182 M. Doh et al.
Out of the full range of assessed constructs, we have selected seven concepts for the
current paper: Internet self-efficacy, Web 2.0 self-efficacy, obsolescence, breadth of
web use, digital media setting, computer/laptop competence, and smartphone/tablet
competence. In addition, demographic variables concerning age, sex, education, partner
status, and income were included.
To measure the digital media setting in one’s household, participants completed a
list of 11 digital devices (computer, smartphone, laptop, tablet, smart-tv, dvd-player,
cd-player, mp3-player, automobile GPS, digital camera, e-book-reader) to indicate the
degree of mediatization. Additionally, data were collected on the utilization of 17
online applications to indicate the breadth of web use [12]. The breadth of web use
index included widely used applications like E-Mail to applications that are more
difficult to use like social networks. For each item, respondents indicated the frequency
of use (daily, weekly, rarely, never). All answers of either “daily” or “weekly” were
added up which resulted in a breadth of web use index ranging from 0 to 17.
For the assessment of specific psychological constructs, we used a three-item
internet self-efficacy scale from Schenk and Scheiko (2011) [25], which is a short
version from Eastin and LaRose [26] with eight items (for example: “I feel confident to
use blogs and make own contributions”). Participants responded on a scale from 1 (not
at all true) to 5 (definitely true). Three items were averaged to form an index of internet
self-efficacy (Cronbach’s α = .84). The same metric was applied for the three items
measuring Web 2.0 self-efficacy that was also adopted from Schenk and Scheiko [25].
Three of the originally five items were selected (for example: “I feel confident trouble
shooting Internet problems”). The internal consistency of the scale was good (Cron-
bach’s α = .82). Obsolescence was a five item measure (Cronbach’s α = .82) developed
by Brandstädter and Wentura [24]. It measures problems of orientation and alienation
in the rapid change of modern societies (“More and more, I have the feeling that I have
been passed over by the times”) and was originally part of a lager assessment of the
“Future Time Perspectives and Future Meaning Scale”. Obsolescence consists of five
Likert-type items rated from 1 (not at all true) to 5 (definitely true). In addition,
respondents were asked to rate their device-specific media competence: “How would
you estimate your abilities/ skills in dealing with the following devices?” These
self-rated competence scores for computer, laptop, smartphone, and tablet were rated
on a scale ranging scale from 1 (no competence) to 5 (a lot) and summarized for
computer/ laptop and smartphone/ tablet.
Differences in characteristics between persons aged 51 to 69 and persons aged 70 to
81 were tested using one-way ANOVA for normally distributed variables, the
Kruskal-Wallis tests for skewed variables, and Pearson Chi2 tests for categorical
variables. Pearson product moment correlation coefficients were calculated using
pairwise deletion. The data were analyzed using STATA 10.1 software (StataCorp LP,
Texas, USA).
6 Results
Table 1 provides information on descriptive statistics and group comparisons for all
variables used in this study. Sample age range from 51 to 81 years with an average of
68.37 years (SD = 6.51). They are highly educated (61.76% university degree), pre-
dominantly male (67.59%), and revealed high levels of self-rated computer competence
(67.59%). As may be expected, high interest in technology and a wide breadth of
online applications and well equipped digital media devices was observed.
We found clear differences among media utilization and personality-related char-
acteristics when we classified our sample in two age groups (51 to 69 years, n = 58; 70
to 81 years, n = 50). The older age group appears to be even more selective in terms of
higher education levels (p < .05), a higher rate of university degrees, a tendency to
larger incomes and a higher proportion of men. The majority of all participants had
longstanding experience with the internet of over ten years. Compared to the younger
age group, older participants showed lower values in both competence measures and
Table 1. Descriptive sample data
51 – 69 yrs. 70 – 81 yrs.
Variable n M SD n M SD p
Age 58 63.45 (4.10) 50 74.08 (3.32) –
Sex (%, female) 58 41.38 50 22.00 <.05
Income (%, low) 4 10.81 0 0.00 –
middle 8 21.62 10 27.78 –
high 25 67.57 26 72.22 ns
Education (%, low) 9 16.36 7 14.00 –
middle 19 34.55 6 12.00 –
high 27 49.09 37 74.00 <.05
University degree (%) 55 52.73 47 72.34 ns
Married/living with a partner (%) 58 82.76 50 82.00 ns
Computer/Laptop competencea 56 4.28 (0.67) 48 3.89 (0.88) <.05
Smartphone/Tablet competencea 53 3.70 (0.89) 43 3.23 (0.77) <.01
Internet use (>10 years) (%) 57 73.68 50 64.00 ns
Digital media settingb 58 8.03 (2.00) 50 6.72 (2.12) <.01
Breadth of web usec 58 8.47 (3.22) 50 6.54 (2.78) <.01
Obsolescenced 58 9.76 (3.31) 50 11.78 (3.90) <.01
Internet Self-efficacye 58 13.19 (1.91) 50 12.18 (2.58) <.05
Web 2.0 Self-efficacye 58 10.43 (3.34) 50 7.23 (3.71) <.001
Note. Higher scores indicating higher ratings of the corresponding scale; ns = not
significant. a Two-item measure ranging from 1 to 5; b Possible score 0 to 11; c Possible
score 0 to 17; d Possible score 5 to 25; e Possible score from 3 to 15
184 M. Doh et al.
*** 60-99 yrs. 14-99 yrs. STE

% *** ***
97
100
100 95
*** *** *** *** ***
86 85 87 87 ***87 ***
82 ***83 79
78
80 *** 72 ***
69 77 77 68
72
75
63
***
61
60
58 58 58 59 58
55
50 48 49 ***
35
40 45 31
40 44 28 37
38
30
26
20 11 24 17
7
20 13 13
8 5 3 10
0
2005
2010
2011
2013
2014
2005
2010
2011
2013
2014
2005
2010
2011
2013
2014
2010
2011
2013
2014
2011
2013
2014
Internet Computer Laptop Smartphone Tablet
Sources: Internet: (N)Onliner-Atlas 2004-2014, each n=30.000 (own analysis); . HUAWEI-
Study: Computer, Smartphone, Tablet 2012-2014, each n=1.000; ARD/ZDF-Study
„Massenkommunikation“: Laptop 2005, 2010, each n=4.500 (own analysis). Test of signifi-
cance with chi2 comparing participants aged 14 -99 years and STE.
Fig. 2. Trends in diffusion of ICT: Comparison of “Senior Technology Experts” (STE) and
representative population data of Germany
self-efficacy scores. The breadth of internet usage as well as the number of digital
media devices was significantly below the values of the younger experts.
In the last decade, senior technology experts have continuously shown higher
diffusion rates compared to the whole German population regarding all ICTs (Fig. 2).
For instance, 67.60% of the experts used tablets in 2014 compared to 26.00% in the
general population (14 – 99 years).
As shown before, age did correlate significantly with all media-related measure-
ments but history of internet usage. In Table 2, a wide variety of digital devices and
usage of online applications was accompanied with higher self-efficacy scores. Those
who scored high on web 2.0 self-efficacy also showed the widest spectrum of internet
applications (r = .57; p < .001). Contrary association were found between obsolescence
and breadth of internet use (r = .24; p < .05). Sex was only associated with a later start
using the internet and a tendency for lower self-rated computer/laptop competence.
Beside demographic variables, the three person-related factors internet/web2.0
self-efficacy and obsolescence explained a significant part (δ adj. R2 = .19) of the
variation of the number of used internet applications.
Table 2. Relationship of socio-demographic and psychological variables with media-related

measures
Competence Competence Digital Internet use Breadth of

Computer/ Smartphone/ media >10 years web usec
Laptopa Tableta settingb
n 104 96 108 107 108
Agea –.26 ** – .24 * – .37 *** – .06 – .25 **
Femalea –.16 .06 – .09 – .30 ** .04
Internet Self-efficacya .65 *** .51 *** .37 *** .35 *** .37 ***
Web 2.0 Self-efficacya .42 *** .37 *** .46 *** .28 ** .57 ***
Obsolescencea –.06 – .24 * – .17 – .06 – .24 *

a
Notes n = 108
7 Discussion
In order to better understand patterns of ICT use in older technology experts, this paper
addresses associations between psychological variables, competence ratings and dif-
ferentiated measures of usage characteristics. Findings demonstrate the special role of
the senior technology experts with regard to their high social-economic and media
psychological resources. Despite the trend of feminization in old age, a marked male
predominance among the senior experts was expected and found, which is related to
low acceptance and diffusion rates among women (see Sect. 2). In the framework of
Rogers’ diffusion theory [14], these senior frontrunners belong to the innovators and
early adopters, not only with respect to the older population but also in comparison to
the general adoption across all age groups. Alongside early adoption, a wide spectrum
of application use and high competence was found. Following Schubert and Büser [27],
this can be framed as “media-related capital” that can be used to enhance participation
and autonomy in everyday life.
As higher scores in self-efficacy measures and low perceived obsolescence were
related to a wider breadth of use and explained a substantial proportion of variance in
regression analyses, our study points to the vital role of those psychological constructs.
With respect to obsolescence, an increase with age was theoretically derived [24] and
found between the two age groups. Especially the link between feelings of obsoles-
cence and competence in smartphones and tablets, but not in computers, is remarkable
and might indicate the sensitivity of this construct to technological and societal chance.
Going further, according to Kaspar, obsolescence was found to mediate the impact of
low technological competence on loneliness [23].
Associations between self-efficacy measures and competence as well as breadth of
use were even stronger, which can be partly due to the technology-specific framing of
186 M. Doh et al.
items in contrast to the general wording of obsolescence which does not explicitly
address technology but a gradual loss of social integration as well as a perceived lack of
competence to cope with modern society. As earlier studies also found a relationship of
self-efficacy and usage patterns [15, 21, 22], our results replicate those findings among
older technology experts.
Several limitations should be noted for this study. First, the study population was
based on a convenience sample. For this paper 12 projects on mobile ICT affiliated to
the German initiative were contacted several times to ensure high diffusion of the
online questionnaire, but as the response rate was about 45% a selection bias cannot be
ruled out. Second, our cross-sectional findings should not be interpreted in terms of
causality. For instance, further longitudinal studies are needed to determine if higher
feelings of obsolescence and lower self-efficacy are consequence or cause of low
competence and low adoption. Furthermore, as our sample population is highly specific
in terms of socio-demographic variables, findings are not generalizable to the wider
population.
Nevertheless, our study is the first to explore both psychological constructs and
differentiated measures of usage and modern ICT adoption among older expert users of
modern ICT. Ongoing longitudinal analyses concerning these experts, as well as a
comparison with their inexperienced counterparts within the German initiative, will
further explore processes and patterns of ICT use and relationships with psychological
variables. In terms of “successful aging” in a technology-driven world, those front-
runners are meant to serve as role-models for inexperienced novices within the ini-
tiative. As self-efficacy can be improved by mastery or vicarious experience [19, 28]
this is a means to help older users to achieve success by providing challenging yet
attainable tasks and by exposure to the expert role model who belongs to the same age
group and conquers the challenge of modern ICT successfully. First hints of
small-scale or case studies [29] indicate that self-efficacy might be a starting point for
interventions in the context of older adults and ICT.
Furthermore, in the ongoing project FUTA, we aim to explore factors facilitating
and hindering the use of new technologies of older adults, for instance usability issues
and the role of social support. In addition, our quantitative findings will be enriched and
complemented with qualitative data generated in focus groups.
Acknowledgements. This ongoing research is supported by the German Federal Ministry of

Education and Research (BMBF). For providing media data we thank TNS Deutschland GmbH,
and the ARD-Werbung SALES & SERVICES GmbH. We thank the Association for Electrical,
Electronic & Information Technologies (VDI/VDE) for valuable comments in earlier stages of
the project FUTA.
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process: a Chinese case study. Educational Gerontology 33(5), 429–450 (2007)
Why Age Is Not that Important? An Ageing
Perspective on Computer Anxiety
Mireia Fernández-Ardèvol1(&) and Loredana Ivan1,2

1
IN3, Open University of Catalonia, Av. Carl Friedrich Gauss,
5 - Parc Mediterrani de la Tecnologia, 08860 Castelldefels, Catalonia, Spain
[email protected]
2
Communication Department, National School of Political Studies and Public
Administration (SNSPA), B-dul Expozitiei, 30A, 012104 Bucharest, Romania
[email protected]
Abstract. We analyze the influence of age on mobile computer anxiety in a

sample of 158 individuals 55+ by means of path analysis modeling. Taking as the
endogenous variable a mobile computer anxiety scale (MCAS, Wang 2007),
models include demographic and socioeconomic variables and a computer expe-
rience scale – based on the familiarity and frequency of use of different information
and communication technologies. Results confirm a positive influence of age on
mobile computer anxiety which is mediated by both socio-economic variables and
computer experience. The influence of age on mobile computer anxiety is com-
paratively low. Age is not the relevant dimension to explain computer anxiety, as
socio-economic background and computer experience have higher explanatory
capacity. This result may explain the inconsistent results regarding the direct
relationship between age and computer anxiety available in the literature.
Keywords: Older people Computer anxiety Romania Survey Path

analysis MCMC bayesian estimation
1 Introduction
“Some people hesitate in using computers for fear of making mistakes. Some people
think they may break the machines if they do not operate them correctly” [1, p. 4].
The pervasiveness of information and communication technologies (ICT) seems to
bring the assumption that individuals are comfortable when using them. Therefore,
research interests on ICT-related problems are currently looking into technology
anxiety that appears when it is not possible for users to check in with ICT as often as
the individual would like (social network sites – SNS, e-mail, voice mail, text messages
or cell phone calls) and which can be related to Internet dependence [2]. But there are
other users who struggle with computers and other (mobile) ICT. Rejection and neg-
ative experiences of ICT use are approached by looking at computer anxiety, as the
negative emotional tendency of an individual towards using computers [3, 4]. Even
though precise and consistent definitions are lacking [5], computer anxiety is often
defined as an individual’s fear or apprehension of working directly with a computer or
the anticipation of having to work with computers [6, p. 2338]. A person may feel

DOI: 10.1007/978-3-319-20892-3_19
190 M. Fernández-Ardèvol and L. Ivan
intimidated, hostile, or worried about social embarrassment or just looking stupid in

current or future use of computers, causing rejection or impacting performance. With
the proliferation of mobile computers, authors (e.g. [7]) have begun discussing indi-
vidual anxiety towards mobile computers, overcoming the limitations of traditional
computer anxiety measures, which look at desktop computers or at wire-based Internet
(see for example Computer Anxiety Rating Scale – CARS, [8]).
Nevertheless, ICT devices have become everyday tools for communication, a
process that affects not only all spheres of life, for instance [9], but different generations
[10] - among others, the younger elderly [11]. As (mobile) ICT are everyday tools, one
may think they are well-appropriated devices which do not generate stress. However,
available evidence shows that (mobile) computer anxiety is not a disappearing phe-
nomenon. For instance, advanced users also face computer anxiety [4] and low self-
efficacy [12]. Contrastingly, a common assumption is that older individuals would be
among the most technology-averse [4] and experience higher computer anxiety.
In this paper we analyze the influence of age on mobile computer anxiety on a
group of adults 55+ by taking into account both computer experience and socio-
economic factors. Research studies on computer anxiety in the case of older people are
limited [6], with [13–15] being exceptions. In addition, there are no studies on mobile
computer anxiety that focus on the older segments of the population. For these reasons,
this is relevant, timely research.
2 Analytical Framework
In what follows we develop the concepts that are the focus of our analysis: Firstly,
(mobile) computer anxiety in relation to age; secondly, in relation to computer expe-
rience. The aim of our empirical approach is to analyze the determinants, or predictors,
of mobile computer anxiety (see [6]). As mobile computer anxiety is a concept evolved
from the discussions around computer anxiety, and given the current proliferation of
mobile computers [7], in the subsequent sections we refer to the main concept -
computer anxiety - and its correlates, with an emphasis on contextual factors.
2.1 (Mobile) Computer Anxiety and Socio-Economic Background

Computer anxiety is more commonly associated with older, less educated adults who
tend to be reluctant to technology in general. Still the evidence of age predicting
computer anxiety is inconsistent [16]. By means of a narrative analysis of the academic
literature on older people and new communication technologies Richardson et al. [17]
argue that computer anxiety reinforces the discourse that considers computers as
potential dividers that marginalize seniors, as the literature sees it as a barrier to
computer use. Kim [18] also develops a critical review on older people and computer
learning and use: Even though older adults are found to be less confident in their
computer knowledge than younger adults, for instance [19], it is not age that is the
explanatory variable of these difference, but the fact that older adults have less
opportunities to use computers. The way a person approaches computer mediated
Why Age is not that Important? An Ageing Perspective 191
communication, at any life stage, is not necessarily determined by age but by a large
number of socio-economic factors, such as status, income and education, that create
different opportunities for individuals [20].
Still, we find a limited number of papers analyzing the relationship between com-
puter anxiety and the social context of individuals. Bozionelos [12], for example, con-
ducted empirical research that analyzes the mechanism to explain the relationship
between socio-economic background and computer use, which considers two inter-
vening variables, computer anxiety and computer experience. He concluded that
“individuals from more privileged socio-economic backgrounds are expected to
demonstrate lower computer anxiety than their less socio-economically privileged
counterparts” [12] p. 727. The author claims that this is the first paper connecting socio-
economic background with computer anxiety. An extensive meta-analysis of the
research on computer anxiety comparing the literature in the 1990 s and in the 2000 s
confirms the lack of interest in this area [6]. The author identified 269 empirical articles
and analyzed the issues that accounted for at least 10 hits in the corpus. She distinguished
computer anxiety antecedents, correlates and outcomes. First, antecedents include per-
sonal characteristics (gender, age, other anxieties, education, personality and profession)
and human-computer interaction dimensions (experience/use, training and ownership).
Second, correlates correspond to self-efficacy, attitude, and perceived ease of use, use-
fulness and satisfaction. Finally, outcomes refer to performance and intent of use. None
of these categories refer to the socio-economic background (SES) with regards to
computer anxiety. In the current research, we argue that the inconsistent results regarding
the relationship between age and computer anxiety can be explained by the assumed
direct relation between the two concepts and the undervalued role of socio-economic
variables (SES) that could play a moderating role.
With this approach, we formulate
Hypothesis 1: The relation between age and mobile computer anxiety, for older
individuals, is mediated by socio-economic variables (SES): work status, level of
education, and household income.
2.2 Computer Experience and Age

Particularly in the case of older people, experience in using computers plays an
important role in individuals’ attitudes towards computers [15]. Chien [1], for example,
highlights lower levels of computer experience among older adults, compared to
younger adults. In addition, Kim [18] explains that younger adults’ computer experi-
ence may cause them higher confidence levels on their abilities to handle computers, a
self-efficacy feeling that would impact their willingness to use a particular technology.
Yet, social aspects should be considered to understand computer experience. Particu-
larly, knowledge acquisition might be shaped by social dynamics, as suggested by the
technology appropriation [21] and technology domestication [22] frameworks. Social
dynamics, conversely, would also shape computer experience and willingness to use
ICT devices.
Although most studies [23–25] found that prior experience in using the computer is
associated with lower computer anxiety, some research studies (e.g. [26]) found an
opposite relation between the two variables: when working with computers increases,
people can become more anxious or develop negative attitudes towards computer.
Certainly the way we operationalize “experience in using computers” could have some
influence on the type of results we get when analyzing the impact on computer anxiety.
We have noticed that most of the cross-sectional research recorded time length of
computer use or self-reported measures of familiarity with different types of applica-
tions – see also [27]. Still a consistent relationship between computer experience and
computer anxiety seems to be recorded in studies when experience has been opera-
tionalized as frequency of use [25, 28]. In this paper we consider the role of computer
experience in mediating the relationship between age and computer anxiety. We
measure computer experience by a composite measurement of self-reported measures
of familiarity and frequency of use.
With this approach, we formulate
Hypothesis 2: The relation between age and mobile computer anxiety, for older
individuals, is mediated by computer experience.
Hypothesis 3: The relation between age and computer experience, for older individ-
uals, is mediated by socio-economic variables (SES): work status, level of education,
and household income.
3 Method
In what follows we describe, first, the process of data collection and the sample
characteristics; and second, the building of the two constructs that are part of the path
analysis models.
3.1 Data Collection and Sample Characteristics

We employed a face to face questionnaire among a convenience sample (N = 158) of
people 55+ living in urban and rural areas in Romania. Students enrolled in a Research
Methods course voluntarily subscribed to be field operators and obtained informal
consent from the participants. The second author designed and supervised the collection
of data. With ages ranging from 55 to 84 years, we targeted two subgroups of partici-
pants, 55 to 64 years of age (n = 91) – most probably active on the labor market, and 65
years and above (n = 67) – at retirement age. The questionnaire included questions about
the familiarity and frequency of use of different technology devices, the purposes of
using specific technologies (work related/spare time activities), mobile computer use
and access to internet, computer anxiety and socio-demographic characteristics: gender,
residence (rural/urban), level of education, income and marital status.
With an average age of 63.9 years (SD = 7.5), there were more women (66.5 %)
than men (33.5 %) among respondents (see Table 2 in the Appendix). Most
respondents reported secondary level of education (49.5 %), with 28.4 % of the par-
ticipants having primary level of education (8 years of school or less) and 21.5 %
graduated from college. The structure of the sample on education level is consistent
with the educational structure for people in Romania having 55 years of age and above
[29]. Regarding the working status, most of our respondents were retired with pensions
(68.4 %), whereas 26 % were full time or part time employees. Compared to the
structure of the Romanian population aged 55+, our sample is overrepresented by
urban areas (76 %), reproducing the socio-demographic characteristics of older people
living in large urban communities.
3.2 Constructs
Computer Anxiety Measurement. Computer anxiety was assessed by Wang’s [7]
Mobile Computer Anxiety Scale (MCAS). Participants answer using a 7 point scale,
from 1 - not anxious at all - to 7 - very anxious, about how they would feel when a series
of mobile computer interactions would happen in the following days. MCAS comprises
38 items divided on seven subscales: (1) anxiety about learning activities (i.e. “taking a
class about the use of mobile computer”; identified as FL in what follows); (2) anxiety
about internet use (i.e. “browsing web pages using a mobile computer”; FI); (3) anxiety
about the equipment limitation (i.e. “using a mobile computer with a limited memory”;
FE); (4) anxiety about job replacement (i.e. “mobile computers would replace some-
one’s job”; FJ); (5) anxiety about computer use (i.e. “working on mobile computer”;
FU); (6) anxiety about computer configuration (i.e. “disassembling hardware compo-
nents, such as memory card, battery”; FC); and (7) anxiety about Internet stability (i.e.
“using a mobile computer in the context of less stable wireless network”; FS). A
Romanian back-translated version of MCAS (38 items instrument) was used in the
current research study. The overall internal consistency was high (Cronbach’s α = .97)
and reliability was good for all seven components (Cronbach’s α ranging from .81 to
.96). We conducted a CPA (Component Principal Analysis) for each subscale, all of
them loading a unique factor with eigenvalue over 1 that explained between 62 % and
84 % of the corresponding dependent variance.
Computer Experience Measurement. We assess participants’ experience with infor-
mation and communication technologies using an ICT experience index that comprises:
(a) familiarity with ICT - measured by the years of using a given communication
technology; and (b) frequency of use, measured by the number of hours spent in using
the device. We conducted a CPA with the 12 variables that gathered this information,
obtaining 5 factors that explained 86.2 % of the variance. While this construct could be
improved (for instance, by adding information on the kind of use of the device) it proved
to have an acceptable internal consistency in the context of the current research
(Cronbach’s α = .79) and the reduction of the dimension was appropriate.
First factor, ICT1, gathered information of experience in using smart phones and
other mobile devices that go online; second, ICT2, experience with laptops; Third,
ICT3, experience with desktop computers and Internet ownership at home; fourth,
ICT4, experience with tablet pc; and fifth, ICT5, experience with mobile phones. These
factors will serve as observed indicators of the construct ‘ICT experience’ in the model.
4 Results
We analyzed the relationship age has with MCAS and ICT experience. On the one
hand, age positively correlates with six of the seven factors that summarize the MCAS
subscales. In the case of not significant correlation (Internet stability or FS) the
parameter is also positive.1 On the other hand, age shows a negative relationship with
the factors that summarize ICT experience.2 We question whether this relationship is
mediated by individual characteristics and computer experience; thus we took a path
analysis approach. Model specification followed the literature review. Figure 1 gathers
the main characteristics of the initial model (Model 1) after adjusting its specification.
Particularly, the model includes direct effects from Age to ICT experience and to
MCAS. The illustration does not include covariances or error terms while for dichot-
omous variables the category under analysis is depicted. For statistical methodology
aspects we follow [30–32].
Fig. 1 Model 1, specification.
We distinguish between observed and unobserved variables. Among the observed

variables in the model (see Table 2, Appendix) there are three exogenous variables of
the model (Age, Sex and Habitat: urban); and three intermediate variables (Occupation:
pensioner, Household income in the last month, and Educational level). The model
1
Pearson’s correlation with Age: FL, .369*; FI, .363*; FE, 0.178**; FJ, .257*; FU, .253*; FC, .242*;
and FS, .088 (* significant at least at 99% level, ** significant at 95%).
2
Pearson’s correlation with Age: ICT_1, −.223*; ICT_2, −.321*; ICT_3, −.334*; ICT_4, .010;
ICT_5, −.212* (* significant at least at 99% level, ** significant at 95%).
includes two unobserved variables: ICT experience and MCAS. The observed indi-
cators of the ICT experience construct are all the obtained PCA factors except one.3
The observed indicators of MCAS are the unique PCA factors obtained for each of the
7 subscales.
We conducted Markov Chain Monte Carlo (MCMC) Bayesian estimations because
the model includes qualitative variables as intermediate variables. In MCMC Bayesian
estimations, goodness of fit is assessed by means of two elements: First, CS or con-
vergence statistic – which must take a value of 1.002 or lower in all the estimated
parameters of the model; second, the posterior predictive p-value (PPP) – which must
reach a value around .50. Model 1 did not achieve convergence. Even though PPP
equaled .50, we discarded Model 1 for not meeting the goodness of fit criteria.
Fig. 2 Model 2, specification and estimated parameters
Model 2 includes a direct path connecting Age and ICT experience but no path
connecting Age and MCAS. It converged in less than 500,000 iterations and PPP
equaled to .50, thus goodness of fit is acceptable. As shown in Fig. 2, all the regression
weights have the expected sign. While most parameters are significant at a 95 % level,
the direct path from Age to ICT experience is significant at a 90 % level. There is one
non-significant parameter, but we decided to keep it because it is one indicator of ICT
experience (ICT4) and its deletion did not impact other elements of the model.
Total effects are the addition of direct effects - represented by arrows directly
connecting two variables - and indirect effects - represented by arrows connecting two
variables through other variables. Table 1 shows that total effects keep the same sign as
direct effects in all cases.
3
We arbitrarily excluded the last one, as PCA returns orthogonal factors.
Table 1. Total effects over intermediate and endogenous variables. Model 2

Age Habitat: Gender: Occupation: Household Educational ICT exp
urban man pensioner income level
Pensioner .038a 0 0 0 0 0 0
Income –.069a .679a .598a –.400b 0 .509a 0
Education -–0.47a .557a .411a 0 0 0 0
ICTexp –.033a .124a .109a –.338a .183a .093a 0
MCAS .044a –.167a –.147a .450a –.246a –.125a –1.406a
Total effects of variables in columns over those in rows. Significance level: a95%; b90%.
5 Discussion and Conclusion
In terms of direct effects, which are equal to regression weights, Model 2 indicates that
age has a positive influence on being a pensioner but negative influence on the rest of
the socio-demographic indicators: household income and educational level (see Fig. 2).
Being male increases household income and educational level but has no effect on the
individual’s occupation. The same is valid when participants live in urban areas,
compared to rural ones. Being a pensioner reduces ICT experience while the higher the
household income, the higher the ICT experience; Besides, educational level was found
to have only an indirect effect on ICT experience. In addition, the higher the ICT
experience the lower the MCA. This result is in line with the findings in the literature
regarding computer anxiety [12, 19, 20]. Thus, socio-economic dimensions, which can
be interpreted as indicators of the opportunities individuals had along their life for
interacting with different ICT, are relevant for understanding mobile computer anxiety
in the case of 55+ individuals.
The total effect of Age over MCAS is statistically significant (see Table 1), showing
a positive influence of age on mobile computer anxiety in the sample of 55+ indi-
viduals under study. Yet, this influence is not direct, as the goodness of fit of Model 1
was not acceptable. Variables acting as intermediaries are occupational status, pen-
sioner; household income; educational level; and ICT experience. The magnitude of the
total effect of Age over MCAS is the smallest one in the model (.044). Similarly, it is
neither the most important factor explaining ICT experience, as Age total effect (.033)
is the lowest one. These results reinforce the idea that age should not be considered the
main explanatory variable of mobile computer anxiety.
In fact, the individual characteristic with the greatest impact on MCAS is occu-
pational status, pensioner (total effect = .450), followed by household income (–.246).
In addition, being a pensioner increases mobile computer anxiety, while higher
household incomes reduce it. The role of ICT experience is key to explain this rela-
tionship, as these are precisely the two variables with higher total effects on ICT
experience (–.338 and .183 respectively).
Therefore, the three hypotheses are accepted.

Hypothesis 1. The relation between age and mobile computer anxiety, among older
individuals, is mediated by socio-economic variables (SES): work status, level of
education, and household income.
Hypothesis 2. The relation between age and mobile computer anxiety, among older
individuals, is mediated by computer experience.
We confirmed the mediated relationship of SES and computer experience. Partic-
ularly, we found a positive influence of age on mobile computer anxiety but it was the
predictor with the lowest explanatory capacity.
Hypothesis 3. The relation between age and computer experience, for older individuals,
is mediated by socio-economic variables (SES): work status, level of education, and
household income.
We found a negative relationship between age and computer experience. In this
case it was partly direct and partly indirect, showing that socio-economic background
could better explain this relationship than age. This evidence supports the idea that
inconsistent results regarding the relationship between age and computer anxiety can be
explained by the assumed direct relation between the two concepts and the undervalued
role of socio-economic variables (SES) that could play a moderating role.
Yet, the empirical analysis could be improved by incorporating other variables that
go beyond the narrow scenario in which computer experience is the only aspect that
directly impacts mobile computer anxiety. Aspects related to learning processes or to
perceived computer self-efficacy would be relevant. In addition, a comparison between
the mobile computer anxiety scale [7] we use here and more traditional computer
anxiety scales (as [33]) would bring nuances of the specific characteristics of the fast-
evolving landscape of mobile ICT devices. Finally, it would be of most interest to
validate the hypotheses from a broader perspective, to replicate the study in other
countries, as cultural differences might play a role.
All in all, our empirical analysis individuals 55+ living in Romania validates that
the influence of age on mobile computer anxiety happens through two different
intermediate channels. One corresponds to social and economic personal context, and
the other corresponds to familiarity and frequency of ICT use. The influence of age is
positive but comparatively low. Other factors, as socio-economic background, have
higher explanatory capacity. Our analysis also confirms that the influence of age on
computer experience is mediated by socio-economic variables and, again, is the pre-
dictor with the lower influence on computer experience in the sample under study. We
can conclude that while age could be used as a proxy of other individual characteristics
in the study of the relationship of (older) individuals with ICT, it should not be
considered the main explanatory variable. That is, age is not that important for
explaining mobile computer anxiety.
Appendix: Characteristics of the Sample
Table 2. Characteristics of the sample (N = 158)
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Values and Ethics in Making Emerging Technologies Work
for Older People
Caroline Holland ✉
( )
The Open University, Milton Keynes, UK

[email protected]
Abstract. Since the early 20th century, population ageing and technological
developments have developed apace. Many social changes took place, including
the development of digital technologies and the ageing of populations worldwide.
The purpose of this paper is to explore the implications of these two phenomena
and to think about how certain values and may be drawn upon to help make
technologies work better for older people as both technology markets and world‐
wide demographic profiles continue to evolve.
Keyword: Ageing Technology Values Ethics
1 Introduction
The twentieth century saw many highly significant and accelerating social changes,
of which just two were the development of digital technologies [1, 2], and the ageing
of populations worldwide [3]. The purpose of this paper is to explore the implica‐
tions of these two phenomena when considered together, and to think about how
certain kinds of values and ethics may be drawn upon to help make technologies
work better for older people as both technology markets and worldwide demo‐
graphic profiles continue to evolve. ‘Values’ are those personal (or collective, within
a group) principles or judgments about what is important in life, contributing to
approved standards of behavior: so for example in balancing freedom of speech
against offending religious sensibilities, different people may value one more highly
than the other. ‘Ethics’ describes a more codified and systematized description of
concepts of right and wrong conduct: so for example most professions identify
ethical standards required of their members in particular circumstances. The paper
draws specifically on the Capabilities Approach, as conceptualized and developed
by Amartya Sen [4, 5] and Martha Nussbaum [6, 7] which focuses on individuals’
capability of achieving the kind of life they value.

DOI: 10.1007/978-3-319-20892-3_20
202 C. Holland
2 Global Ageing
Global Age Watch data [8] shows that by the early 2010s it was already the case that
marginally more older people lived in developing1 countries compared to developed
ones, and it is projected that by 2050 over three-quarters of older people worldwide will
live in those countries that are currently regarded as developing. At the same time
number of countries where the relative proportion of older people is expected to exceed
30 % will expand, especially in the northern hemisphere, to include most developed
countries. So, by that point, numerically most older people will live in the developing
countries, but with higher densities of older people in developed ones. Hence globally,
the technology landscape of ageing ranges from the very rural and remote to the very
dense and urban, and from areas of great wealth through to those of deprivation. This
global ageing is itself taking place within the wider global context of interconnected
changes. The concept of globalization, originally used in economics, is now often used
to describe other aspects of global interaction including issues relating to the environ‐
ment, culture, media, and technologies. In an interconnected world, and one where
corporate power and influence can equal or indeed exceed that of nation states, is it
possible for an ethical approach based on shared values be brought to bear on the devel‐
opment and use of technologies where older people, by design or not, are potential end
users?
3 Values and Ethics in ICT Development
ICT for ageing is a field in which much has already been written about older people’s
use of technologies, often either to understand their attitudes to using/not using tech‐
nologies, and in particular to explore the efficacy of specific of assistive technologies in
the growing telehealth and telecare markets. In contrast relatively little attention has
been paid to the fundamental values that underpin the whole ICT ecology, and the nature
and location of the decision-making that embeds specific values within technological
environments that we all share. Tim Berners Lee [9] acknowledged that the world wide
web represented humanity connected, involving both the “wonderful” and the “ghastly”.
He commented that it is now time for big communal decisions: “In front of us are two
roads - which way are we going to go? … Are we going to continue on the road and just
allow the governments to do more and more and more control - more and more surveil‐
lance? Or are we going to set up a bunch of values? Are we going to set up something
like a Magna Carta for the world wide web and say, actually, now it’s so important, so
much part of our lives, that it becomes on a level with human rights?” This begs the
question as to which values can and should and could be incorporated into such an
agreement, as well as how those values would then be accounted for in professional
ethical frameworks.
1
Both the concept and the definition of ‘developing’ countries are contested, but for the purposes
of economic differentiation and development aid a (varying) number of nations are so identified.
GDP per capita compared to other nations is a key indicator.
Values and Ethics in Making Emerging Technologies 203
Much of the thinking behind this paper stems from Value Ageing [10], a Marie Curie
Industry‐Academia Partnerships and Pathways Action (2010–2014) with nine European
partners from a range of sectors and disciplines: the Centre for Science Society and
Citizenship (CSSC) in Rome; The Austrian Academy of sciences, Institute for tech‐
nology assessment; Technalia, Spain; the Free University of Brussels; Frontida Zois Ltd,
Greece; INNOVA SPA, Italy; the Netwell Centre, Ireland; Queen’s University Belfast,
UK and Vegan Solutions SRL, Italy. The goal was to foster co‐operation between non‐
commercial and commercial organizations on a joint research project aimed at exam‐
ining, through policy documents and examples of practice, the Fundamental Values of
the European Union in Info‐Communication Technology (ICT) for Ageing were evident.
These EU values are set out in Articles 1–2 of the union, and are a requirement for
membership [11]. They are based on concepts of respect for human dignity, liberty,
democracy, equality, the rule of law and respect for human rights, including the rights
of persons belonging to minorities. Societies of the Member States are to be character‐
ized by pluralism, non-discrimination, tolerance, justice, solidarity and equality between
women and men. Hence for the purposes of the Value Ageing analysis, the concepts of
non-discrimination, dignity and inclusion are described as values.
Value Ageing also looked at statements of Corporate Social Responsibility within
ICT companies in Europe and found that they rarely paid much attention to ageing. Of
those that did, several were working with health monitoring technologies rather than
social, gaming or more general use technologies. Many companies recognize the stra‐
tegic importance of universal design solutions, and increasingly, the need to involve
end-users in the design process, but the notion that older people are conservative, brand-
loyal consumers reluctant to get involved with cutting-edge technology has affected
corporate decision-making.
3.1 Non-discrimination
Age has its own salience, reflected both in bodily change (physical and mental) and in
social position, but nobody is just old. Other factors, for example gender and sexuality,
wealth, education and culture have an impact on how a person experiences both ageing
and technologies. The impact of individual’s life experiences and their lifetime exposure
to technologies do affect (thought they do not entirely define) how, in later life, indi‐
viduals respond to new technologies. This leads to the first of our ‘bunch of values’ when
it comes to ageing: no discrimination on the grounds of age. Value Ageing suggests that
ICT developments can produce conditions that risk discrimination for older people, but
they can also provide solutions to those risks: ‘it is generally not ICT developments per
se that threaten dignity and inclusion, but the ways that specific ICTs and services are
conceived, designed, promoted, introduced, used, supported, and monitored’ [12].
Crucially, this includes simultaneously taking on board that there are age-related condi‐
tions, such as compromised hearing or visual impairments, that must be considered: and
that older people are not all the same with respect to any of those conditions.
204 C. Holland
3.2 Dignity
This leads to consideration of another fundamental value: dignity. The Value Ageing
definition of dignity built upon Nora Jacobson’s notion of dignity encounters, i.e. the
value that belongs to every human being simply by virtue of being human. [13]. She
argues that the actors, the setting, and the wider social/political context where encounters
take place can all either promote or violate dignity. Value Ageing researchers used this
notion of dignity encounters as one of the ways to understand the impact of uses of
technologies with older people. Risks of indignity arise when people’s different needs
are ignored (‘batch treatment’) and when older people are not in control or in a position
to make informed choices. Issues of the affordability of technologies, and local access
and cultural practices are highly significant - especially when thinking about the range
of places where older people live.
One of the key mechanisms for preventing discrimination and dignity violations is
the inclusion of older people is the development process for new technologies, from
concept to marketing. For many of those commentating on the Value Ageing findings,
the direct participation of older people in design was essential to impart age-friendly/
all-age-friendly values. The main caveat here was the position of people living with
middle and late stage dementia without the cognitive capacity to participate directly.
Here commentators talked about the role of relationships: ‘In dementia, concepts of
autonomy, choice and participation don’t necessarily apply the same way and become
less useful – the route to dignity is in relationships and behavior’ [14]. In this approach,
it is how ICTs are used and the awareness of others of the ethical issues involved in the
use of technologies with people with dementia that matters: ‘dignity requires a step-by-
step approach that can take on board everyone’s viewpoint’ [14].
3.3 Inclusion
This brings us to the next value: inclusion – where the corollary is exclusion. Older
people are relatively at risk of social exclusion for a number of reasons. While old age
does not of itself cause loneliness or social isolation, there is an important relationship
between the two, not least because reduced income and mobility can reduce opportuni‐
ties for social interactions. Phillipson and Scharf [15] pointed to some other key causes
including the cumulative effects of disadvantage across the life course; the effects of age
discrimination; the vulnerability of older people as a group to local changes such as
population turnover or general economic decline; and particular age-related character‐
istics such as disability and widowhood. Older people in any case tend to spend more
time alone in the home or immediate home environment compared to younger adults:
and those who live alone are more vulnerable to exclusion from civic and cultural activ‐
ities. Technologies and ICTs in particular have the potential for a huge beneficial impact
on the loneliness that can often accompany old age. Digital communication has the
power to ameliorate physical problems of mobility or face-to-face communication and
allow older people to remain engaged socially and with the life of the city. One obvious
social space where people might go when physical space gets difficult is the social media.
Older people have initially been slower to get engaged in numbers in social platforms
but the popularity, where they can be accessed, of touch screen tablets (by-passing PCs)
and visual communications with family are groundbreaking for both online and physical
inclusion of older people [16].
4 Capabilities
As one of the mechanisms for exploring values in ICT, Value Ageing used the idea of
Capabilities, a human rights-based concept developed by the philosopher Amataya Sen
[17] and subsequently developed by others including Martha Nussbaum [18]. Sen stated
that the importance of ‘real’ freedoms, meaning that for each person the ability to trans‐
form available resources into activities of value to them personally was an individual
process. Nussbaum elaborated on this concept to describe ten categories of personal and
social circumstances that she argued were fundamental to democracies. Value Ageing
considered that technologies have the potential to enhance people’s lives across most of
her categories, stating that:
‘However a consequence of the Information Society is that for full engagement in almost all
aspects of contemporary life in Europe (and increasingly, world-wide) ICTs are an essential
component of how people can control their environments. For this reason we suggest that to
Nussbaum’s tenth category, ‘Control over one’s environment’ should be added (C) Technolog‐
ical: Being able to access, on an equal basis, the essential technologies of civic and social
engagement and personal support’ [19].
According to Value Ageing, ICTs can support older people’s independence and safety,
including the physical, cognitive, emotional, social and cultural aspects of their daily
lives. They can support social inclusion by opening up avenues to physical and online
communities, support dignity, and encourage self-fulfillment by allowing older people
to continue longer with chosen activities. But they also have the potential to damage
well being if used inappropriately: or if not used - for example on the grounds of age -
when they could be of benefit. The work of Value Ageing included examples of good
practice where efforts had been made to produce beneficial dignity encounters between
older people and technologies, and to support their capabilities. One of the characteristics
of these examples was that thought had been given to ageing as an issue, for example
through co-design and the involvement of older people at pilot stages of development.
Another was that when it came to introducing a technology to individuals, assumptions
were not made about their needs and receptiveness. However
5 Emerging Technologies
However the general principles of this kind of rights-based approach to values and ethics
requires further consideration for emergent technologies. Any consideration of how in
recent years high-tech companies have chosen to absorb emergent ones indicates a lot
about where the locus of decision-making lies. Whereas companies that became large
and affluent might have started out with one idea for a technological innovation, the
drive in most cases has been for large corporates to expand into the future by bringing
206 C. Holland
in and integrating, developing, or in some cases sitting on emerging and early stage
concepts. It could be argued that this is just business, but in the case of technologies that
can impact profoundly on the personal lives of older people, Berners Lees’ call for a
values in the world wide web applies equally here because ICTs have the potential to
support people as they age, including supporting independence and perhaps more
importantly, social connectedness. They can also be harmful if used inappropriately, but
perhaps the lager risk at present is that of potentially beneficial technologies bypassing
older people because of faulty assumptions about their needs and preferences. Three
examples of emergent technologies illustrate this argument for integrating values and
ethics in development - implants, robotics, and big data.
5.1 Implants
The idea of having foreign objects inserted into the body is not immediately appealing
to most people but tooth implants, piercings for jewelry, and contact lenses, all demon‐
strate that in context such practices can become accepted and commonplace. Implants
for the medical mitigation of physical deficit or injuries are also familiar: for example
fully implantable pacemakers have been around since 1958 and are becoming increas‐
ingly fine-tunable. Brain-Computer Interaction research and development has tended to
be focused primarily on neuroprosthetics applications aimed at restoring damaged
hearing, sight and movement, with the first neuroprosthetic devices implanted in humans
in the mid-1990s. As the group most at risk from these conditions, older people need to
be involved in these developments. The medical implications of most of these proce‐
dures means that legitimate practitioners will be bound by professional ethical standards,
but it is important that values also come in to play because values may drive or influence
decisions about the direction or pace of developments, or indeed attitudes to who
‘deserves’ or ‘can benefit from’ such interventions.
5.2 Robotics
Despite the industrial application of most current robots, the popular picture of a robot
is of a humanoid assistant. In the case of older people, suggested uses for robotics have
included companionship, service, and lifting and handling [20]. Following the 2011
earthquake and tsunami in Japan, recognition was given of the usefulness of some older
survivors of the Paro baby seal robot for emotional comfort [21]. At another scale,
exoskeletons, emerging from military, industrial, and rehabilitation research, can
harness the motions of the human body and the intentionality of the human brain within
an engineered framework to enhance power, reach and durability, or they could supple‐
ment or replace human assistants. Developments like these might also become the new
mobility scooter, able to go up and down stairs like an advanced Darlek. In spite of a
relative lack of convincing empirical studies, age-related uses of robotics is on the radar
of developers. Middle aged and older people need to be more involved in discussions
about future prospects, and consulted about their effectiveness and acceptability in
everyday life to ensure their inclusion among the beneficiaries of developments in
robotics.
A further aspect of the relationship between robotics and ageing was exemplified by
work from Accenture showing the correlation between the incidence of industrial robots,
aging populations, and GDP per capita. Hence Japan and Germany have been leading
in this area, with younger, poorer economies such as the Philippines, South Africa, India,
Malaysia lagging behind. The Accenture argument is that moving to low-wage econo‐
mies for manufacturing is no longer the only or best way to control costs in labour-
intensive manufacture and indeed automation and robotics technologies have been
quietly developing in capability and affordability. They showed that countries with
ageing populations have also been the most active in adopting technology (measured as
robotics), as well as maintaining high GDP per capita levels, to stay competitive:
‘Indeed, countries like Germany, Japan and South Korea excel in quality automotive
manufacturing, the benchmark of industrial production’ [22] – this is an example of
population ageing interacting with commerce in a context that is not directly about older
people as consumers.
5.3 Big Data

Technologically what has counted as big data has changed along with computing
capacities: for non-technologists it is generally regarded as data produced at a volume
which humans cannot process. This means that most people must rely on experts to
interpret data being generated at volume. At this scale the idea of dignity vested in
consent becomes ill-fitting: for example it is not possible to opt out of outdoor surveil‐
lance by municipal or private CCTV cameras.
The relative recentness of issues of big data means that, as with the general popula‐
tion, older people are often unaware of the implications for them personally of the
handling of their personal data. Uses such as health informatics; ICTs in public places –
for example through public information installations; ICTs to monitor people in public
places and gather information about them; and the collection of data about people as they
go about their business, for example using payment, swipe or access cards, are generally
unfamiliar to most people, including older people [23]. This presents a real risk of discrim‐
ination and dignity affronts, giving rise to concern for the kind of human values-led
ethical framework suggested by Berners Lee. Big systems such as e-health, e-govern‐
ment and e-transport, and systems talking to systems in the internet of things, place
personal consent in a different context. That is, while in some circumstances a person can
opt out – for example by declining to allow their personal health data to be included in a
database – they can’t opt out of the higher level changes to how systems conduct busi‐
ness and run services - and these systems are very rarely designed with ageing in mind.
In this kind of situation an opted-out person might in effect become an excluded person.
The position that older people very often find themselves in now, is one of being excep‐
tionalised by digital systems. By this I mean that there may well be the possibility to opt
out of using a digital default mode – for example by completing a form in hard copy
rather than online - but that may well be seen by the organization as creating work and
something of a nuisance, and singling out the older person as someone incapable of doing
a simple online task. Hence very often an older person who is not comfortable with digital
systems will compromise by getting help from someone who is: potentially surrendering
208 C. Holland
privacy and dignity in the process. Yet as with social media many of these barriers could
be reduced by paying better attention to ageing and creating systems that work better for
people with low technical skills.
6 Summary
This paper has considered some of the issues of use and non-use of technologies that
are emerging within a globally ageing population, looking through the lens of values
and ethics. It argues that non-discrimination, dignity, social inclusion and respect for
individual capabilities cannot be ignored if our increasingly technologically infused
environments are going to work better for older people – and indeed for everyone.
Because age is only one of many aspects that make up a person, an individuals’ capacity
to respond to technologies should not be defined in terms of age, even though the effects
of human ageing often need to be taken into account in everything from design to the
implementation of services and marketing of products. Focusing on respect for the indi‐
vidual and their capabilities will make it more likely that new technologies are intro‐
duced in a responsible, effective and non-discriminatory way, but in a globalized
commercial ICT environment there is no guarantee that these values will be key consid‐
erations. As new technologies emerge, so will new ethical dilemmas: for example iden‐
tifying who will be responsible for accidents caused by driverless vehicles. In large part
these will be resolved eventually by codification in law and professional standards.
However it is less likely that the core values described in EU Articles 1 and 2 will
coincide exactly with the core values of all of the transnational corporations and other
entities working in emerging technologies. For those who highly value respect for human
dignity and rights, liberty, democracy, equality, and the rule of law, there is a continuing
need for vigilance and information sharing about the effects of new technologies on
individuals and communities. For developers, practitioners and users of technologies,
paying attention to the experiences of older people is one of the ways of recognizing
potential challenges and opportunities in making technologies work for people as well
as organizations.
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Accessing InterACTion: Ageing
with Technologies and the Place of Access
Constance Lafontaine(&) and Kim Sawchuk
Department of Communication Studies, Concordia University, Montreal, Canada

{constance.lafontaine,kim.sawchuk}@concordia.ca
Abstract. In this paper, we reflect upon our participation in a pilot digital

literacy project titled InterACTion currently being deployed in low-income
housing for seniors the city of Montreal. To assess the complexities of access
with respect to ageing in this real world setting, we draw upon Clement and
Shade’s ‘Access Rainbow Model.’ We use the InterACTion project as a case
study and formulate seven lessons that we have gleaned in the carrying out of
the project, each of them working to display intricacies of access within a
context of precarious ageing and situated engagements with technologies. Our
interest in drawing from the model lies in our understanding of access a
multi-layered concept that relies both on the establishment of technical
requirements and on a host of entangled conditions that are crucial in deter-
mining an individual’s ability to use digital technologies.
Keywords: Access rainbow Access Digital literacy Place Ageing
1 Introduction
This paper focuses on the relationship between ageing and digital technologies, with a
particular emphasis on devices such as laptops, tablet computers and other hand-held
portables. These are the devices that promise users wireless telecommunication or
networked services anywhere and at anytime. Within North American society, the
wireless industry is burgeoning. However, if one looks at data on adoption rates, one
notices that the demographic groups with one of the lowest rates of use are older
adults.1 However, is age itself the only relevant “variable”? What other factors
determine or predict access to mobile networked devices and services?
To understand barriers to access in relation to older adults, we reflect upon our
participation in a digital literacy project titled InterACTion currently being deployed in the
city of Montreal in Québec, Canada. InterACTion is conducted with a community-based
group of social service providers, Groupe Harmonie, an organization that works with older
1
For instance, we can draw here from data gathered by the Centre facilitant la recherche et
l’innovation dans les organisations, à l’aide des technologies de l’information et de la
communication (TIC) (CEFRIO) for the province of Québec in 2010. Though their report noted
the high uptake of technology by seniors, it further affirmed that ICT use by older Québécois lagged
substantially behind that of younger cohorts. Some 54 % of adults over 55 regularly use the Internet
(more specifically this corresponds to 68 % of those 55 to 64 and 40 % of those over 65). Some 75 %
of the general population uses Internet while 94 % of those 18 to 24 use it) [1].

DOI: 10.1007/978-3-319-20892-3_21
Accessing InterACTion 211
adults living in social housing in the downtown core of the city. InterACTion began in
April 2014 and is on-going as of the writing of this paper. InterACTion is not only a pilot
project, but it is a unique case study, for it highlights the desires, needs and barriers to
access faced by groups of seniors living in poverty and requiring social assistance in an
urban centre. While perhaps not the ideal target market from an industry standpoint, the
case of InterACTion draws attention to real-world challenges for understanding the
experience of access faced by many older adults in a moment where there is increasing
pressure to go digital and greater gaps between rich and poor across the globe.
To assess the complexities of access with respect to ageing in this real world
setting, we draw upon Andrew Clement and Leslie Shade’s ‘Access Rainbow Model.’
The Access Rainbow Model is a heuristic tool that identifies seven interrelated layers
that pose a challenge to access provision including: carriage facilities, devices, software
tools, content/services, services/access providers, literacy/social facilitation and finally
governance as an integrated socio-technical architecture [2]. For Clement and Shade,
layers are stacked and ordered yet overlapping, and all of them are necessary for a
model that “forms the basis of a workable definition of ‘universal access’” [2, p. 1].
Lower layers of the rainbow point to the technical dimensions of access, upper ones
refer to social aspects while “the main constitutive element is the service/content layer
in the middle, since this is where the actual utility is most direct” [2, p. 4].
In using the Access Rainbow Model we reflect upon our engagement with the
InterACTion project tin their intertwined complexity, by this particular population. As
Clement and Shade argue, communications infrastructures are already less accessible to
certain individuals in society, often to those who continually experience systematic
disadvantages connected to age, gender, income, language, ethnicity, disability and so
on [2, p. 5]. Our interest in the model lies in its definition of access as a multi-layered
concept that relies technical requirements and a host of conditions that determine an
individual’s ability to use digital technologies at different moments in the life course.
While we agree that the model offers an important set of guidelines we also contend
that in a real world setting, the image of a layered rainbow is not so easily applied. The
strands not only overlap, but they are interwoven at each and every moment.
To unravel this interweaving, we offer seven lessons gleaned in the carrying out of
the project. The lessons we articulate display the intricacies of access within an overall
context of precarious living, and also emphasize the emplacement and contextuality of
access. What does it mean for this particular group of people to age in a digital world
full of promises of unfettered connectivity and technological abundance? How do we
understand access within this context, and from their points of view? What lessons can
be learned from the project?
2 Situating InterACTion: The Context
The non-profit community organization Groupe Harmonie2 was created in 1983.

Groupe Harmonie works with seniors (55 and over) in Montreal who are dealing with
addictions, including alcohol, drugs and gambling. Groupe Harmonie reached out to
2
www.groupeharmonie.org.
212 C. Lafontaine and K. Sawchuk
our research team Ageing, Communication, Technologies (ACT)3 to jointly put in place
the InterACTion digital literacy workshops in two social housing buildings (habitations
à loyer modique or HLM) located in the downtown core of Montreal. The two
buildings are meant to house adults 60 and over who are living later life in a state of
poverty (generally understood to be living with less than $27,500 CAD annually) [3].
The initial task consisted in installing routers in the common rooms of each
building to provide an Internet connection in the shared spaces to all residents without
cost or password requirements. The InterACTion project intended to provide a phys-
ical, material connection, what Clement and Shade identify as the availability of an
adequate carrier mechanism that is fundamental to the provision of services online. As
it soon became obvious, enabling this physical infrastructure is far from being tanta-
mount to access. To introduce the new infrastructure, a router with a connection, we
organized welcome parties in the common rooms in April 2014 in the hopes of meeting
residents, sharing food with them, explaining the project, asking them about their
interests, showing them laptop and tablet computers, and instigating them into par-
ticipating in future workshops. We initiated a door-to-door survey: some thirty resi-
dents responded to a simple bilingual questionnaire. With our initial impressions and
feedback obtained from the welcome party and the survey, we purchased equipment
(four laptops and six tablets), and we launched monthly workshops in each of the
building (thus organizing two workshops per month). The workshops last two hours
and consist in matching an elder with a device and a tech mentor. The one-on-one
tutorial demands of the project, though an effective way to teach technology use and to
share knowledge and to engage with elders, are labor and resource-intensive. We have
had to mobilize a sufficient number of bilingual tech mentors (often student volunteers)
and equipment for each session. At times, the demand has been so high that we have
had to turn away elders from the workshops.
To date, we have given eleven monthly workshops in each building, for a total of
twenty-two workshops and, at time of writing, the workshops are still ongoing. Since
the beginning of the project, over fifty elders have partaken. There are about five
residents who regularly attend and there are an average of six residents per work-
shop. Thus far, ten students and postdoctoral researchers have been involved from
Concordia University and Université de Montréal, four members of Groupe Harmonie,
a number of volunteers affiliated with Groupe Harmonie, as well as an administrator
from Concordia University. During this time we have taken field notes and engaged in
informal discussions with the participants.
As the name suggests, the overarching goal of InterACTion is to create a convivial,
intergenerational environment for elders to learn how to use digital technologies,
identified by Clement and Shade as fundamental to access through social facilitation.
But also, and in no small part, an important goal was to find a way for Groupe
Harmonie to promote positive human interactions among the building residents
(whereas interactions can be fraught and conflictual at times), and to put to good use the
common rooms that often go unfrequented by building residents. Here, situating the
workshop within the often difficult milieu of shared spaces of low-income housing is
3
www.actproject.ca.
key to understanding learning as situated in particular spaces and places: in the HLMs,
people 60 and over are living together in small individual apartment units out of
necessity, and not necessarily out of choice.
3 Lessons
3.1 Lesson 1: Situated Methodologies—Accessing Information on Access

One of the key ways of determining access, and constructing meaningful interaction, is
to have information on the needs of the population with which one is working. One
way to access information is through participant observation. When we organized
‘WIFI welcome parties’ in the common rooms of both buildings in April of 2014, we
quickly noticed that seniors seemed more excited about using the tablets and exhibited
less curiosity about the laptops at this event. The tablets were initially objects of desire.
They captured the interest of residents in the particular setting of the WIFI welcome
parties, where the use of the equipment was more cursory, often done while standing
up, and thus differed from the longer-length one-on-one workshop setting that would
later be adopted. This initial reaction, combined with the societal enthusiasm towards
the adoption of mobile tablet computers, and other research that points to the poten-
tially high acceptance and satisfaction rate of seniors learning with tablets [4, 5] led us
to speculate that they would serve as a preferred means of technological engagement in
the workshops. This was not to be the case.
A second means of accessing information about access is through more formal
mechanisms. As a follow-up to this initial encounter, we fashioned a short bilingual
ten-question survey to learn more about the interests, desires, and current
computer-related skills of the residents who would be our potential workshop partic-
ipants. We asked what technologies they had on hand. Given the low level of access to
both devices and networked services, an online survey would have been impossible: a
door-to-door approach throughout both buildings was the only option. Yet even this
proved to be a challenge. In a situation of social housing where people rely on gov-
ernment subsidies and are often under the scrutiny of governmental agents and agencies
looking to cut benefits, people are suspicious and mistrustful. Residents most often did
not want to open the door to talk about computer and mobile computing workshops.
When people did answer the door and agreed to the survey, the desire for interpersonal
contact meant that a short survey that would normally call for about five minutes often
took over forty minutes and we often had to fill it out with them.
What did we learn from those who allowed us access to their homes and who were
willing to share information through our survey? The thirty people who did answer
indicated that there was a high level of interest in free Internet workshops and that if the
community rooms could be opened for this purpose they would be used. The survey
further outlined future challenges: the majority of respondents were self-assessed
beginners or had “average” level of skills. When we asked what they would like to
learn they suggested the some of the basics of Internet searches as well as email, Skype,
photo scanning, Facebook and YouTube. But we also noted that “What would you like
to learn?” had been the question that was most skipped. This query was frequently met
with uncertainty, and nearly a third of the respondents opted not to answer, unable to
point exactly to what they wanted.
A large majority, 84 %, thought that learning more about digital technologies
would have an impact on their lives with some 44 % indicating that they thought that
this impact could be “big”. Yet this assessment of potential impact was speculative, for
the majority of our participants cannot afford to keep up with technology, had never
used a digital device for a sustained period of time in their working or personal lives
and could not pay to ensure steady, in-home access to an Internet service provider or
for a cell phone. As we learned from these first two forays into making contact,
methodological inquiries are situated in place and are related to questions of access.
Even the ways that one would find out about access is related to access to current
technologies.
3.2 Lesson 2: Physical Affordances and Human Encounters

Clement and Shade point out that devices come with particular affordances, which, as
other researchers in HCI have indicated, are often seen as some of most important and
significant barriers for older adults [6]. Indeed access is often, from this perspective,
tantamount to the design of the device and software. While for Clement and Shade, the
main issue of access is the high cost of the devices, they also point to usability as a key
issue. This intermingling of cost and design affordance became evident in our inter-
actions with seniors partaking in InterACTion, yet even here there are important les-
sons about what can be learned from working with a group of people over time.
Given our observations at the WIFI welcome party, we initially expected tablets to
be more popular. Yet within the first few workshops, it became clear that many of the
seniors found it easier to work with laptops. The swiping motion needed for tablet-use
was foreign to many residents and, for some, impaired hearing, vision and trouble with
fine motor skills became important factors in selecting specific devices. For these
participants, the keyboard and screen of the laptops provided them with better affor-
dances. In fact, many of the women, in particular, commented that they were more
comfortable with keyboards because of their previously acquired typing skills, which
they had developed through a gender-based formal education and work experience.
This skillset served as an entry-point, bolstering confidence in their ability to use the
technologies. In this instance, while it may have initially seemed as if the design of the
tablets offered better affordances, for some of our participants their histories of prior
computer use and their embodied subjectivity influenced their choice of device, a point
on the importance of embodiment in computer learning supported by the research of
Christina Buse [7].
3.3 Lesson 3: Affordances: Financial Considerations

Ironically, although laptops were preferred by the majority of our participants, when
making the decision about what they might buy most did not chose this option. Despite
the participants’ discomfort and reluctance in using tablets, and their preferred use of
laptop computers at the workshops, those planning to purchase equipment decided to

buy android tablets because of their relatively lower cost. These devices have been
primarily devised for mobile use and networked connectivity, immediately articulating
them to our regulatory context of pricing and contracts in Canada [8]. More affordable
and potentially networked, the tablets were not used in the workshop setting, but later
purchased anyway: the cost associated with services that is key.
Most residents do not have Internet access in their own units and cannot afford it
seeing as the average cost in Canada is extremely high—approximately $75 a month—
and it goes up incrementally every year and often requires a credit card or a credit
check. Without either a credit card or a sustained connection in their own apartments,
the participants cannot partake in being systematically networked, and therefore see
little reason to own either a laptop or tablet. Yet the desire to be a part of a networked
society they cannot necessarily afford is present. In one instance, a participant who is
using the workshops to write her memoirs on a laptop computer does not need Internet
access for the purposes of her project. Yet she still wants connectivity explaining this is
“because I am missing out on so much.” Likewise, because of limited funds, she has
decided a tablet is a better option for her because of cost, despite the fact she prefers
typing on a laptop.
Through this and other conversations with these elders, participants have openly
talked about their desires: they imagine themselves wandering the city with tablets
surfing the Internet in a park or going to a coffee shop to be a part of a larger cultural
scenario of anywhere, anytime connectivity. However, for most of these residents the
reality of ownership and unfettered connectivity is quite different: it is mitigated not
only by the affordances of the device, but by their ability to quite literally afford to stay
connected [9].
3.4 Lesson 4: Language and Literacies

There are other factors of exclusions linked to socio-economic class that influence the
ability of our participants to interact with these devices- and to engage in digital
learning. While Clement and Shade emphasize the need to enable digital literacy and of
the requirement of a “broad range” of knowledge and skills required to engage with
network society, general literacy is not included in their figuration of access. Lower
levels of literacy (along with lower levels education and income) have elsewhere been
identified as correlated with non-use of ICTs [10], a consideration that needs to be
foreground in an examination of the conditions of access of an older and impoverished
population. Canadian data from the International Adult Literacy and Skills Survey
reveals that only 18 % of respondents over 65 are situated at a literacy level of 3 or
above—level 3 being “the desired threshold for coping well in a complex knowledge
society” [11]. A large majority (82 %) of Canadian elders have been deemed to have
general literacy challenges. Surprisingly, Canada has significant gaps between levels of
general literacy, and has a notably “higher proportion of its population at the highest
and lowest levels” [12] thus emphasizing the need to consider general literacy as an
important marker of social inequality in the country.
A number of the residents who participate in our workshops have variable levels of
literacy that impact their ability to use the Internet, and especially to conduct
keyword-based searches. Although this was not an intended part of our project, those
least able to read and write are excluded from the workshops either through their
reluctance to engage in a public setting that would put their lack of literacy on display
or through an exclusion fostered by our reliance on flyers and posters to promote
workshops.
As Clement and Shade suggest “[k]nowledge includes an understanding of the
various types, sources and uses of a global networked information; the role of infor-
mation in research and problem solving; and systems whereby information is stored,
managed and transmitted” [7, p. 11]. Such information and network literacy assumes an
array of knowledge related to information retrieval. With years of Internet use, one
builds a verbal and visual lexicon to facilitate software use. Even simple web searches
rely on decoding expressions like “quick search,” “I’m feeling lucky” and icons like
drop-down arrows, hour and magnifying glasses and spinning beach balls all have a
symbolic value that is learned progressively by users and comes to be taken for granted
as it is incorporated into what Bourdieu would call one’s “habitus” [13]. The perceived
work required to acquire this lexicon can feel like a daunting task for beginners as we
found in our workshops. Everything needs to be explained and sometimes translated.
Here again, the term literacy is even connected to an ability to operate in several
languages in a context like Québec, a province that primarily comprises Francophone
speakers who are living in a digital world dominated by English.
Most of our participants are Francophone and they immediately found themselves
with the need to customize language settings, as many are ill at ease with the default
English configuration of software. This was also the case for several seniors who had
visual impairments, and who were burdened by dim screens and unable to read the
small characters. In these cases, device and software settings needed to be altered.
Customization and the use of optional accessible interfaces require a level of profi-
ciency beyond those afforded by a beginner, presenting a further accumulation of
barriers and challenges to be confronted and overcome.
3.5 Lesson 5: Interpersonal Barriers and the Need for “Warm Experts”
As a way of promoting universal access, Shade and Clement emphasize the need for
community centers and libraries to provide free internet access, and to be located in
proximity to the dwellings of people who would need them the most [2, p. 11].
Ironically, there are libraries and community centers near the two HLMs providing
WIFI access, public computers, and affordable workshops on a regular basis. Although
we found that these seniors were aware of these devices and publicly available services,
our participants remained reluctant to make use of them. They are trapped in a double
bind. On one hand they were unprepared to use the technologies alone, did not have
access to them in their rooms, nor did they have anyone to turn to in their immediate
environment. On the other, they were unwilling to reveal their precarity, alienation and
isolation in a public setting. Conversely, the one-on-one setting of the InterACTion
workshops for these participants broke through the barrier of personal reluctance by
favoring an approach based on establishing a rapport between participants. Clement

and Shade point to the importance of “the social aspects of learning” and the impor-
tance of “informal learning environments” where “local experts” can engage in casually
mentoring future users, on the job and on the fly, in situations with little pressure. In
such contexts, the acquisition of skills occurs in informal settings.
By emphasizing a bi-directional sharing of knowledge and stories our students and
other tech-mentors became surrogates for what Maria Bakardjieva [14, 15] calls ‘warm
experts,’ or “a close friend or relative who possesses relatively advanced knowledge of
computer networks and personal familiarity with the novice user’s situation and
interests” (15, p. 74). Warm experts, for Bakardjieva, are uniquely enabled to find
potential uses and relevance of the Internet for the learner because they have estab-
lished relations of trust over time. In this respect, understanding “human practices” not
only as a set of skills, but as a part of a set of affective and emotional approaches that
can facilitate learning in a particular place, are essential and entangled factors that are
typically associated with the macro-level.
3.6 Lesson 6: Spaces of Access

Clement and Shade note that “[g]overnance is about the ways in which decisions are
made concerning the development and operation of the information/communication
infrastructure” [2, p. 12]. In their discussion of governance, they make specific and
explicit reference to a policymaking perspective, which they tie to the actions and
abilities of actors from the public and private sectors who play a politically prominent
role in affording access to individuals through the imposition of particular legislative
choices.
Our case study brings us to consider that governance, regulation and communi-
cation infrastructure operates in smaller and more precise, but still immensely powerful
ways at local levels- in place. For instance, the structural specificities of the HLM have
had an impact on the ways seniors can engage with technologies on site. Despite the
fact that WIFI had been made available in the common room, what we imagined as
their potential digital commons, the daily realities of the residents have an impact on
the uses of this common space, which in turn influence their ability to practice their
newly acquired skills to reinforce their learning between our monthly sessions.
While there may be technical connectivity in the common rooms, taking care of the
issue of “carriage” identified as essential within the Access Rainbow Model, there were
in fact few opportunities for the residents to frequent the space and to use this Internet
access to reinforce their learning. Over the years, the use of the common room has been
an instigator of conflict among the residents, some of whom are grasping with physical
and psychological impairments, and who are not all co-habiting by choice. The com-
mon space is kept locked by the governing body that controls this residency. Unless
Groupe Harmonie is physically present in the building to prevent both conflict and
theft, access is restricted for residents who might want to avail themselves of this
common connectivity. In addition, because of the lack of funding to the maintenance of
the building, no one is currently employed to clean the common room, which deters its
use. Keeping the room locked has become a cost-efficient alternative to finding
adequate staff or volunteers to do rudimentary maintenance. Because of these cir-

cumstances, a bench located outside of the locked common room has become an
important and impromptu point of access in one of the buildings, as the WIFI network
is still accessible from there and the bench itself has no history of contestation.
3.7 Lesson 7: Meaning, Purpose and Intermittent Access

Clement and Shade identify content as a principal constitutive element, explaining that
“this is where the actual utility is most direct” [2, p. 4]. Yet what does this mean for
users living in conditions where there is an accumulation of barriers to access? One of
the key elements that determined return participation for our residents was finding a
reason to use the internet, a sense of purpose—what Jean-Paul Sartre [16] identifies as
a ‘project’—that actually imbue the sessions with meaning. Likewise, Clement and
Shade suggest that content and services “must include the ability for users to interact in
a creative and participative fashion as well as simply to receive stimuli” [2, p. 10].
These reasons expressed for wanting access to content were often very personal in
nature. For instance, one woman who intermittently attends found exercises that could
improve her back pain and learned to look them up on YouTube videos. As she doesn’t
own a computer, she used the sessions to write down notes on paper that she then could
carry up back up to her unit. Even without owning a computer, motivated by her own
discomfort and desire for information on her pain management, she nevertheless found
a way to make our sessions and even the most intermittent of access work to her
advantage.
Information management in the context of intermittent access became key. Because
they lacked ownership of a device, participants tended to forgo an interest in learning
that would require sustained use or daily management (such as email) or use that
demanded privacy (such as Skype). As such, the workshops became focused on
acquiring information and viewing online materials that would not conflict with these
concerns. As they perceptively pointed out to us “why would I get an email address, if I
can only look up my emails once a month?” This situation of lack of sustained access,
and temporal breaks between sessions, also indicates the ability of residents to find
resilient and creative workarounds. Some began to carefully think about topics they
wanted to look up and learn in the intervals between workshops. Others began con-
versations amongst themselves in the preceding weeks in preparation for the work-
shop. Many, in fact, now come with a list (written or otherwise) of things they
specifically want to do or ask during sessions.
For example, two participants are working together to make lists of old buildings in
the Montreal downtown area that have been important places in their lives, such as
hospitals, schools, churches, parks and restaurants. They began using the monthly
sessions as dedicated time to work on what they termed as “their project” of searching
through city archives to find information and photos. During the workshop, they used
these Internet results as prompts to tell stories about their childhood and how their lives
in Montreal have overlapped indicating the juncture of finding meaningful content with
“the social aspects of learning” taking place in “supportive” and non-censorious
environments, which as Clement and Shade argue “are often overlooked” [2, p. 12].
4 Conclusion
From the momentary ephemerality of the WIFI welcome party, to the door-to-door
survey through our sustained and on-going encounters with the participants in the
InterACTion project, it is evident: first that when dealing with human computer inter-
action, it is vital to consider the question of place and its important as a mediating variable
that influences digital learning of those who are older. Second, we can see how uneven
access to wealth has its tributary effect differential experiences with ICTs. It creates
precarious and often difficult living situations for our InterACTion participants; it entails
a host of interconnected material and other barriers to the uses and learning of technol-
ogies that require troubleshooting and innovative workarounds. Industry documents are
often geared towards exploiting the untapped seniors market and promote a language of
innovation that makes it seems that all have unfettered access to perpetual connectivity in
a networked society. This focus does not take into account the large percentage of elders
in ‘developed worlds,’ such as those living in Montreal HLMs, who are not living in the
top 20 percentile. In this context, the realities of poorer seniors are neglected experiences
from the purview of a pure marketing mentality towards ICTs, which is typically
interested in the lives of affluent seniors who have ‘successfully aged.’
By reflecting on the lessons presented above, we want to inform the development of
future learning activities and indeed inclusive design approaches. But mainly, we
intend to emphasize that learning to use technologies always occurs within the spec-
ificity of context—in the dynamics of a place and at a particular time. In this con-
sideration of place, the age and generation of the users are vitally important to consider.
However, they are not the only consideration. Any thinking about digital technologies
and elders cannot be done apart of an understanding of variegated ageing experiences
and the realities of precarious ageing, where socio-economic factors of exclusion such
as class, education, and language (and also culture, race, ethnicity and gender) are
compounded when it comes to interacting with technologies.
As we have seen, the Access Rainbow Model usefully pinpoints the multi-faceted
and complex ways that access to digital technologies and learning are connected in
specific places. In their discussion of access, Clement and Shade make use of the
rainbow as a visual metaphor for the plural barriers to access, yet the assemblage of
layers cannot aptly reflect the entangled nature of the ways access is lived by the elder
participants of the InterACTion workshop. Barriers to access are plural, certainly, but
they merge, overlap and crisscross persistently: they are closer, perhaps, to a ball of
string or a bowl of rainbow-colored spaghetti than a neat rainbow.
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Review of Empirical Research in Recent
Decade About the Use of IT for Older Adults
Yi-Chang Li(&)
School of Health Policy and Management, Chung Shan Medical University,

Taichung, Taiwan
[email protected]
Abstract. This study reviews the research articles about the use of IT for older
adults’ from 2009–2015. As result, fourteen articles published in peer reviewed
journals are reviewed.
Keywords: Older adults IT usage Review
1 Introduction
The ability to use Computer and information technologies (CIT) is now assumed by
most commentators to be a prerequisite to living in the information age. Access to CIT
is a major public policy concern as technology has become a significant aspect of
economic, social and health equity. Recent data suggest that although CIT use is lower
among older, as compared to younger adults access is increasing among older people.
Wagner et al. (2010) reviewed 151 existing articles covering the period 1990–2008 and
provides a holistic view of the field. They concluded that “although there has been
significant research dedicated to the use of computers by older adults, there is certainly
still a plethora of opportunities for further study in this increasingly relevant field.”
Therefore, the purpose of this study is to review the articles that published after 2009
(the end of year in Wagner et al. (2010)’s review). We focus on the papers that reported
empirical research findings in order to realize the research progress in these years.
2 Material and Method
The articles for this review were gathered by searching various databases for peer
reviewed journal articles on the subject of CIT use by older adults. However, only
papers with empirical research (such as survey, experiment, focus group, interview, and
secondary data) are included. Search strings included reference to aging (age or aging
or old or older or senior or older adults) as well as reference to computer use (computer
or Internet or web or interface or mobile phone). Two research assistants and the author
are responsible for categorizing the select papers according to their journal discipline,
theoretical basis, IT related activities, and variables. Inter-rater reliability was calcu-
lated using a variant of Cohen’s kappa as 0.72 which is above the recommended
minimum of 0.70 (Straub, et al., 2004).

DOI: 10.1007/978-3-319-20892-3_22
222 Y.-C. Li
3 Results
As in Table 1, most journals we found were in HCI discipline, followed by healthcare

journals. Table 2 revealed that half of the papers did not outline their theoretical basis.
TAM was the most frequently used theory in the study of older adult’s CIT usage. In
Table 3, survey was the most frequently used data collection strategies, followed by
secondary data (such as government or industrial investigation). Table 4 revealed that older
adults use ICT for general use, contact people or relatives and health-related activities.
Table 1. Journal dicipline and number of empirical research published

Journal discipline Number of empirical research published
HCI 6
Healthcare 5
Psychology 1
Gerontology 1
Education 1
Table 2. Theoreitcal basis

Theory Number of empirical research published
TAM 5
UTAUT 1
TPB 1
No obvious theory mentioned 7
Table 3. Data collection strategies

Strategies Number of empirical research published
Survey 8
Secondary data 4
Experiment 1
Focus group and interview 1
Table 4. ICT used for older adults

ICT used Reference
General ICT Mitzner et al. 2010
Pan and Jordan-Marsh 2010
Cotten et al. 2012
Choi and DiNitto. 2013
Ramón-Jerónimo et al. 2013
Elliot et al. 2014
Mobile phone Kurniawan, 2008
Conci et al. 2009
Social network ICT Chung et al. 2010
Hogeboom et al. 2010
(Continued)
Review of Empirical Research in Recent Decade 223
Table 4. (Continued)
ICT used Reference
health-related ICT Chu et al. 2009
Choi, 2011 Or et al. 2011
Heart and Kalderon, 2013
4 Conclusion
CIT was found to be promising in increasing the quality of life for older adults.
However, successful use of CIT by older adults is predicated on systems that are
designed to accommodate the needs and preferences of this user group. As Chen and
Chang (2011) concluded that “Technology has been shown to be beneficial to older
people, but a digital divide remains”.
Appendix
Paper Data collection and Major findings Note (the kind of

sample IT,
theoretical basis,
journal discipline)
Kurniawan, 2008 Online survey of 100 1. Older people are ∙ Mobile phone
people passive users of ∙ No obvious
mobile phones theoretical basis
2. Gender differences ∙ HCI
*
in preferred design this paper might be
features were neglected by
observed, with Wagner et al. 2010
women focusing because it was
on haptic aids and published in Dec.
men on perceptual 2008.
aids.
Chu et al. 2009 Experiment Reduction in ∙ Internet health
137 adults aged 65+ computer anxiety information
and increases in resources
computer ∙ No obvious
confidence and theoretical basis
computer ∙ Healthcare
self-efficacy in
retrieving and
evaluating online
health information
if older adults
receiving
computer training
(Continued)
224 Y.-C. Li
(Continued)
in appropriate
situation
Conci et al. 2009 Survey 1. Intrinsic ∙ Mobile phone
740 questionnaires motivations play ∙ TAM
from people over 65 an important role ∙ HCI
years old albeit always
mediated by
utilitarian
motives.
2. A strong influence
of the reference
social group
(children and
relatives) in
increasing the
utilitarian values
of the use of
mobile phones.
Chung et al. 2010 Survey 1. Perceived ∙ Online
989 (11.1 %) out of usefulness community
8935 positively affects participation
behavioral ∙ TAM
intention, yet it ∙ HCI
was determined
that perceived
ease of use was
not a significant
predictor of
perceived
usefulness.
2. Negative
relationships
between age and
Internet
self-efficacy and
the perceived
quality of online
community
websites.
3. Moderating role of
age was not found
(the relationships
among perceived
ease of use,
perceived
usefulness, and
intention to
participate in
online
communities do
(Continued)
(Continued)
not change with
age.)
Hogeboom et al. Secondary data Frequency of ∙ Internet use for
2010 A sample (n = 2284) contact with social networking
from the 2004 wave of friends, frequency ∙ No obvious
the Health and of contact with theoretical basis
Retirement Survey family, and ∙ Education
was used. (adult attendance at
age > 50) organizational
meetings (not
including
religious services)
were found to
have a significant
positive
association with
Internet use for
adults over 50.
Mitzner et al. Focus group 1. Older adults ∙ Computer
2010 Older adults (n = 113) perceive the technologies
benefits of ∙ TAM
technology use to ∙ HCI
outweigh the
costs of such use.
2. Perceived benefits
of use and ease of
use have positive
influence on
computer use
Pan and Survey Perceived useful (+) ∙ Internet adoption
Jordan-Marsh 374 (age 50 +) Perceived ease use behavior
2010 Beijing, China (+) ∙ Extended TAM
Social norm (+) ∙ HCI
Internet adoption
intention:
Perceived useful (+)
Social norm (+)
(Continued)
226 Y.-C. Li
(Continued)
Facilitating condition
(+)
Perceived ease use:
Older (+)
Choi, 2011 Secondary data derived Older-adult users of ∙ HIT usage
from US National general health ∙ No obvious
Health Interview services were theoretical basis
Survey (NHIS) 2009 more likely to use ∙ Healthcare
aged 65 or older HIT than nonusers
(n = 5294) of general health
services, while
older-adult users
of specialized
health services
were not different
from nonusers of
specialized health
services in their
odds of HIT use.
Or et al. 2011 Survey Perceived ∙ Web-based
101 participants of usefulness, interactive
home care nursing perceived ease of self-management
practice with adults use, subjective technology
with chronic cardiac norm, and ∙ Unified Theory of
disease healthcare Acceptance and
knowledge Use of Technology
together predict (UTAUT)
most of the ∙ Healthcare
variance in
patients’
acceptance and
self-reported use
of the web-based
self-management
technology.
Cotten et al. 2012 Secondary data A positive ∙ Internet use and
Retired Americans age contribution of depression
50 years or older using Internet use to ∙ No obvious
data from the Health mental well-being theoretical basis
and Retirement Survey of retired older ∙ HCI
adults reducing
(Continued)
(Continued)
depression
categorization by
approximately
20–28 %.
Choi and DiNitto. Face-to-face or Due to lack of ∙ Low-income
2013 telephone surveys exposure to disabled and
980 recipients of computer/internet homebound
home-delivered meals technology; lack adults’ and older
in central Texas (78 % of financial adults’ Internet
were age 60 years and resources to use.
older and 22 % under obtain computers ∙ No obvious
age 60). and technology; theoretical basis
or medical ∙ Healthcare
conditions,
disabilities, and
associated pain
that restrict use.
Heart and Survey ∙ ICT use was ∙ Readiness to
Kalderon, 2013 123 respondents(63 determined by adopt
from the US and 60 accessibility of health-related ICT
from Israel.) computers and ∙ Theory of planned
support and by behavior (TPB)
age, marital ∙ Healthcare
status, education,
and health.
∙ Health was found to
moderate the effect
of age, healthier
older people being
far more likely to
use computers than
their unhealthy
coevals.
∙ Only perceived
behavioral control
(PBC) emerged as
significantly
affecting intention
to use a computer
Ramón-Jerónimo Survey ∙ Male elders seem ∙ Internet use
et al. 2013 492 individuals over to perceive more ∙ TAM and gender
50 years old in Spain usefulness due to differences for
higher levels of older adults
ease of use than ∙ Gerontology
woman.
(Continued)
228 Y.-C. Li
(Continued)
∙ Ease of use is also
better explained by
the level of
enjoyment for
males.
Elliot et al. 2014 Secondary data ∙ Socioeconomic ∙ ICT use
a sample of status (SES), age, ∙ IT and depressive
community-dwelling and cognitive ∙ Psychology
older adults from the function accounted
National Health and for approximately
Aging Trends Study 60 % of the
(N = 6,443). variance in ICT
use.
∙ SES was a stronger
predictor for
Blacks/African
Americans,
whereas cognitive
function was a
stronger predictor
for Whites.
∙ ICT use was
unrelated to
depressive
symptoms or
well-being.
However, it acted
as a moderator,
such that
limitations in
activities of daily
living (ADLs) was
a stronger predictor
of depressive
symptoms for high
ICT users, whereas
ill-health was a
stronger predictor
for non/limited
users.
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6 (2012)
Exploring the Impacts of Age and Usage
Experience of e-Service on User
Perceived Web Quality
Chien Hsiang Liao(&)
Department of Information Management, Fu Jen Catholic University,

New Taipei City, Taiwan
[email protected]
Abstract. Prior studies have shown that while older adults use web or
e-service, they tend to rely on user accessibility guidelines or friendly web
appearance. For instance, older people have difficulty reading text presentations
more than younger readers. Inappropriate design decisions might create barriers
for older people. However, this causality might not be entirely resulting from
age. This study found that the usage experience of e-service is also strongly
associated with the requirements of web quality for users as well. The empirical
study was conducted on a sample of 318 users of using web services. The results
reveal that the requirements of web quality (including web appearance, context
quality, and technical adequacy) between older and younger adults are not
significantly different. Instead, users with low usage experience require greater
web quality than experienced users.
Keywords: Web quality Age Usage experience Satisfaction Trust
1 Introduction
With the development of information technology, the Internet or web-based environ-

ment has become an important service channel for users. More specifically, providing
services via electronic channel are available all day long for users and will lead to lower
service cost for enterprises. Therefore, both users and enterprises increasingly use
e-service to interact with each other. However, not all users are adept at using e-service
or self-service technology at the website. Prior studies have shown that while older
adults use web or e-service, they tend to rely on user accessibility guidelines or friendly
web appearance (Hart et al., 2008). For instance, older people have difficulty reading
text presentations more than younger readers. Inappropriate design decisions might
create barriers for older people (Curran et al., 2007). That is, the requirement of web
contents and appearances for older adults is higher than younger adults. However, as
the Internet becomes popular, more and more elderly people have begun to use
e-service. This study proposes that age may no longer be the key determinant affecting
their requirements of using e-service. Perhaps some latent factors need to be explored
and discussed. For example, usage experience has been proven to be associated with
user behavior, intention, and performance (Taylor and Todd, 1995; Venkatesh and

DOI: 10.1007/978-3-319-20892-3_23
Exploring the Impacts of Age and Usage Experience of e-Service 231
Davis, 1996; Venkatesh et al., 2012). Specifically, because experience makes knowl-
edge more accessible in memory, it will help users to shape intention (Taylor and Todd,
1995). Accordingly, the purpose of this study is to compare the impacts of age and
usage experience of e-service on the associations between e-service quality, satisfac-
tion, and trust (see Fig. 1). The results will help us determine which factor will be the
main moderator affecting the user perceptions. The discussions of research constructs
are mentioned as follows.
Fig. 1. Research model
2 Literature Review and Hypotheses Development

2.1 The Linkages Between e-Service Quality, Satisfaction, and Trust
As mentioned, the Internet is an important service channel for users. User perceived
quality on the Internet has been measured and operationalized by many studies. First of
all, perceived e-service quality is defined as the pure information component of a
customer’s service experience provided in an automated fashion and without human
intervention (Sousa and Voss, 2006). With most virtual channels encompassing more
than the Internet, many instruments have been developed to assess the quality of
Internet portals, such as web quality. In this vein, this study also anchors discussion on
the Internet as the primary e-service channel of service delivery.
e-service quality has been operationalized by several instruments, such as e-service
quality (E-S-QUAL) by Zeithaml et al. (2000; 2002), Website quality (SiteQUAL) by
Yoo and Donthu (2001), Web quality (WebQUAL) by Aladwani and Palvia (2002), and
Quality of e-service (QES) by Fassnacht and Koese (2006). However, most of these
instruments have been developed primarily for online shopping context (e.g.,
E-S-QUAL and SiteQUAL), with the exception of WebQUAL (Gummerus et al., 2004).
232 C.H. Liao
More specifically, WebQUAL is established to measure perceived web quality from the
perspective of Internet users (Aladwani and Palvia, 2002). This instrument is suitable for
general context of web-based applications, whether website is concerned with online
shopping or not. Therefore, this study uses WebQUAL to measure the e-service quality.
WebQUAL measures four sub-constructs of web quality: content quality,
appearance, technical adequacy, and specific content. Content quality consists of
information usefulness, completeness, accuracy, and conciseness. Appearance means
the proper use of fonts, colors, multimedia, and other website attractive factors.
Technical adequacy consists of security, system availability, customization, and other
technical abilities. Specific content reflects concerns to finding specific details about
products/services, including contact information and detail information related to
customer service. However, helping customers find detailed information about service
(i.e., specific content sub-construct) seems to be a passive way of providing e-service.
Besides, customers might be unable to find or access desired information due to
unfamiliarity with e-service (e.g. a new self-service technology). According to the
study by Aladwani and Palvia (2002), they conducted three rounds of Delphi method
and concluded that technical adequacy, web content and web appearance are three
major web quality dimensions. Therefore, this study merely focuses on the discussion
of these three sub-constructs and excludes specific content sub-construct from the
WebQUAL.
Most importantly, user perceived e-service quality is strongly associated with
overall user satisfaction (Collier and Bienstock, 2006; Fassnacht and Koese, 2006) and
trust (Liao et al., 2011). More particularly, user satisfaction and trust have been proven
to be influenced by the four characteristics of the Internet, such as system availability,
privacy, information comprehensiveness, Website design, and so forth (Bauer et al.,
2002; Muylle et al., 2004; Wolfinbarger and Gilly, 2003). These characteristics will
attract users to stick Internet or use e-service, and thereby influence their satisfaction
and trust after they visited the website (Muylle et al., 2004). Therefore this study
proposes that the causal associations are positively supported no matter what user’s
age and past experience.
H1. Perceived e-service quality is positively related to satisfaction.
– H1a. Web appearance is positively related to satisfaction.
– H1b. Context quality is positively related to satisfaction.
– H1c. Technical adequacy is positively related to satisfaction.
H2. Perceived e-service quality is positively related to trust.
– H2a. Web appearance is positively related to trust.
– H2b. Context quality is positively related to trust.
– H2c. Technical adequacy is positively related to trust.
2.2 The Moderating Effects of Age and Usage Experience

This study expects the impact of e-service quality on satisfaction and trust to be
moderated by age and usage experience. Firstly, older adults tend to face more diffi-
culty in operating complex information, thus influencing their learning performance of
new technology (Morris et al., 2005; Venkatesh et al., 2012). Computer-based
information requires several cognitive skills that may result in age differences in the
website task performance (Priest et al., 2007). Therefore, compared with younger
adults, older adults require higher e-service quality helping them familiar with e-service
functions. In this vein, this study predicts that age has positive moderating effect on the
relationship between e-service quality and user satisfaction and trust. That is to say,
user with higher age will lead to more significant relationship between e-service quality
and user satisfaction and trust.
H3a. The impact of e-service quality on user satisfaction is positively moderated by

age.
H3b. The impact of e-service quality on trust is positively moderated by age.
Prior experience of using a technology is typically defined as the passage of time from
the initial use by an individual (Venkatesh et al., 2012). Ajzen and Fishbein (1980)
suggest that feedback from past experiences will influence various beliefs and future
behavioral performance. For instance, the strength of the relationship between infor-
mation usefulness and intention to use is stronger for users with higher experience
(Saeed and Abdinnour-Helm, 2008). Also, information technology usage may be more
effectively modeled by experienced users (Taylor and Todd, 1995). Accordingly,
before inexperienced users use a new e-service, they may require higher e-service
quality than experienced users. In this vein, this study proposes that past experience has
negative moderating effect on the relationship between e-service quality and user
satisfaction and trust.
H4a. The impact of e-service quality on user satisfaction is negatively moderated by

past experience.
H4b. The impact of e-service quality on trust is negatively moderated by past
experience.
3 Methodology
3.1 Data Source

Data are collected from a university in Taiwan. This university has been established for
more than 50 years and establishes an e-service website for alumni in 2003. The Public
Affairs Office (PAO) of this university is an institution responsible for alumni
e-services, including helping the alumni to seek lost-contact alumni, apply for diplomas
of graduation online and so on. Totally, 318 respondents are selected from a web
survey at the PAO website. Of the sample, 53 % are male and 65 % graduate more than
5 years ago.
3.2 Measures
E-service Quality. This study uses the WebQUAL instrument (Aladwani and Palvia,
2002) to measure user perceived e-service quality because it is suitable for non-profit
234 C.H. Liao
web-based context. A total of 15 items are used to measure WebQUAL (see Table 1);
specifically, 3 items for technical adequacy, 3 items for content quality, and 5 items for
web appearance.
Satisfaction and Trust. User satisfaction is the result of a process of evaluation and is
benefit for relationship development (Bauer et al., 2002). Trust reflects a willingness to
rely on an exchange partner in whom one has confidence (Morgan and Hunt, 1994).
Both satisfaction and trust are usually measured as the relationship with the service
provider based on all the service experiences (Garbarino and Johnson, 1999; Roberts
et al., 2003). Thus, this study uses 3 items and 2 items to measure the overall satis-
faction and trust with website.
Table 1. The questionnaire items of research constructs

e-Service Quality
- Technical adequacy (Aladwani and Palvia, 2002)
TA1. This website looks secure for providing service functions.
TA2. Web pages load fast on this website.
TA3. This website is always up and available.
- Content quality (Aladwani and Palvia, 2002)
CON1. The content of this website is accurate.
CON2. The content of this website is complete.
CON3. The content of this website is clear.
- Appearance (Aladwani and Palvia, 2002)
APP1. This website looks organized.
APP2. This website uses multimedia features properly.
APP3. This website uses fonts properly.
APP4. This website uses colors properly.
- Satisfaction (Garbarino and Johnson, 1999)
SAT1. I am satisfied with using this website.
SAT2. I am satisfied with services from this website.
SAT3. The website strengthens my relationship with the university.
- Trust (Roberts et al., 2003)
TRU1. This website is trustworthy.
TRU2. This website has high integrity.
Age and Past Experience. The respondents are asked to answer to their age and past
experience of using e-service. According to distribution of age, research respondents
are divided into three groups. The first group (A1) is the young adults less than 30 years
old. The second group (A2) is between 31–40 ages, and the third group (A3) is older
adults more than 41 years old. Likewise, the respondents are divided into three groups
based on their past experience. The first group (P1) is the inexperienced users whose
usage experience less than 1 time, and the second group (P2) is the users who have had
e-service experiences 2 or 3 times. The third group (P3) is experienced users who have
had more than 4 times e-service experiences before.
4 Results and Discussions
The hypothesized associations are tested by using regression analyses. As expected, web
appearance, content quality, and technical adequacy are positively related to satisfac-
tion. The beta coefficients (β) of these three sub-constructs are .236 (p <= .001), .224
(p <= .001), and .360 (p <= .001), respectively. The H1 is supported. Similarly, trust is
positively influenced by web appearance (β = .174; p <= .01), content quality (β = .121;
p = .063), and technical adequacy (β = .437; p <= .001). The H2 is supported as well.
The results are corresponded with the findings by prior studies (Cristobal et al., 2007;
Table 2. The results of regression analysis on different age groups

Dependent variable Satisfaction
Age groups A1 (young adults) A2 (middle-aged adults) A3 (older adults)
Web appearance .239** .175 .348+
*** *
Technical adequacy .407 .267 .252
Content quality .176* .361** .338+
*** ***
F value 76.000 25.107 14.673***
Adjust R2 .526 .472 .570
Dependent variable Trust
Age groups A1 (young adults) A2 (middle-aged adults) A3 (older adults)
Web appearance .124 .157 .454*
*** ***
Technical adequacy .427 .479 .442*
**
Content quality .210 .032 -.187
F value 56.815*** 15.048*** 8.897***
Adjust R2 .452 .342 .433
+
: p < .1; *: p < .05; **
: p < .01; ***: p < .001
Yang et al., 2005), suggesting greater web quality will lead to higher user satisfaction
and trust. But this study duplicates the study and suggests that the causal association is
supported without interference from user’s age and past experience.
To test the H3, the results are analyzed based on different age groups (i.e., A1, A2
and A3 groups). Table 2 shows that web quality is positively related to user satisfaction
for young adults. But, for older adults, the effects of web appearance and content
quality merely approached significance (p value ranges from .05 to .1). The causality
from web quality to user satisfaction is not more significant for older adults, showing
that the H3a is not supported. Similarly, due to lack of obvious evidences, the H3b is
not supported. A possible explanation is that because the Internet is becoming
increasingly popular, most of older adults are used to use e-service and thereby do not
pursue higher demands for web quality.
For the H4, Table 3 shows that web quality is strongly associated with user sat-
isfaction for users with low usage experience, but this association is not significant for
users with high usage experience. The result suggests that the causality from web
236 C.H. Liao
quality to user satisfaction is much more significant for people who seldom use
e-service. Corresponded with the expectation, the H4a is supported. The finding reveals
that the requirement of web quality is determined by user’s usage experience rather
than user’s age. The enterprise managers could spend more efforts on catching users’
past experience and develop appropriate strategy to serve them. For instance, managers
can use cookie or system log at the website to analyze users’ usage experience. If they
are inexperienced users or did not use the e-service before, the website will pop up a
message inquiring the users about the needs of user guideline or friendly web
appearance.
Furthermore, there is no enough evidence to show the H4b is supported. According
to the results of the H3b and H4b, only technical adequacy positively and significantly
affects trust in any groups. A plausible explanation is that trust represents a much
deeper relationship with user (Corritore et al., 2003). Compared with web appearance
and context, providing better technical adequacy (e.g., system security) has a more
direct impact on trustworthy relationship. The finding reveals that if enterprise man-
agers aim to establish trustworthy relationships with users, they should be thinking
about how to enhance website technology, such as customization, privacy, security and
so on.
Table 3. The results of regression analysis on different usage experience groups

Dependent variable Satisfaction
Usage experience groups P1 (low) P2 (middle) P3 (high)
Web appearance .195* .256* .293
***
Technical adequacy .388 .340*** .231
**
Content quality .227 .212* .290
***
F value 57.138 32.236*** 14.644***
2
Adjust R .498 .460 .539
Dependent variable Trust
Usage experience groups P1 (low) P2 (middle) P3 (high)
Web appearance .174+ .152 .231
Technical adequacy .417*** .448*** .505*
Content quality .126 .112 .079
F value 38.122*** 22.911*** 15.358***
Adjust R2 .396 .374 .552
+ * ** ***
: p < .1; : p < .05; : p < .01; : p < .001
5 Conclusions
The aim of this study is to compare the impacts of age and usage experience on the
relationship between perceived web quality and user satisfaction and trust. This study
found that older adults do not necessarily require greater web quality to serve them
because the Internet is becoming popular and they are used to use e-service. In contrast,
inexperienced users (or users with low usage experience) require greater web quality
than experienced users. Therefore, regarding to website design pursuing higher user
satisfaction, the importance of usage experience is higher than user’s age.
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Acceptance of ICTs by Older Adults: A Review
of Recent Studies
Qi Ma1(&), Ke Chen1, Alan Hoi Shou Chan1, and Pei-Lee Teh2

1
Department of Systems Engineering and Engineering Management,
City University of Hong Kong,
Kowloon Tong, Hong Kong
[email protected]
2
School of Business, Monash University,
Selangor Darul Ehsan, Malaysia
Abstract. Objectives: Issues surrounding aging and information communica-

tion technologies (ICTs) are of critical importance. This study aims to identify
the determinants of the acceptance of ICTs innovations by older adults, and
discuss the research gap in the gerontechnology literature.
Methods: Research articles were selected from four multi-disciplinary dat-
abases (SCOPUS, ProQuest, EBSCOHOST, Science Direct) from 2004 to 2015.
Articles were filtered by “Older than 55”, “healthy”, “acceptance”, “ICTs”, etc.
Finally, a total of 29 papers including qualitative, quantitative and mixed-method
research are used in this study.
Results: The majority of these studies indicated that older adults have a
positive attitude towards using ICTs. The findings summarized ICTs-related
technologies in five basic domains: Intelligent monitoring, Health care delivery,
Online services, Social communication, and Internet & Computer. The review
gathered and classified important acceptance factors into six themes: Perceived
Benefits of Use, Subjective Norm, Perceived Behavior Control, Perceived
Usability, Affections, and Socio-demographic Mediators.
Keywords: Review Older adults Information communication technologies

(ICTs) Technology acceptance
1 Introduction
Information and communications technologies (ICTs) is often used as an extended

synonym for information technology (IT), but is a more specific term that stresses the
role of unified communications and the integration of telecommunications (telephone
lines and wireless signals), computers as well as necessary enterprise software, mid-
dleware, storage, and audio-visual systems, which enable users to access, store,
transmit, and manipulate information. The increasing permeation of information
communication technologies (ICTs) in our society leads to the challenge that every-
body needs to interact with ICTs in daily life. Populations in many countries are aging
at the same time, and the current cohort of older adults has experienced ICTs for a

DOI: 10.1007/978-3-319-20892-3_24
240 Q. Ma et al.
relatively short period in their late lives [1]. Older adults differ considerably from
young users in Human Computer Interaction (HCI) and they often meet difficulties
while trying to accept and use new technology products and services. There remains
an age-related digital divide that older adults lag behind in using and benefiting from
information and communication technologies [2]. Venkatesh concluded that older
adults, like anyone else, accept and adopt technology when it meets their needs and
expectations [3, 4]. However, Verdegem and De Marez [5] reported that technology
innovations often fail to be fully utilized since less attention is given to user accep-
tance. Thus, to ensure that older adults are able to adapt to the new information
environment, there were some studies that explore from different perspectives the
factors that influence the acceptance of information and communication technologies
among older adults. Increasing attention on the acceptance of ICTs-related innovations
by older adults makes a review of the recent studies on this topic timely and
meaningful.
This study reviewed the existing research from a multi-disciplinary and holistic
view to identify the predictors and areas concerned in the acceptance and usage of ICTs
by older adults, and attempted to provide directions for further technology acceptance
research within this specific group. A systematic review of qualitative, quantitative, and
mixed methods studies examined the following research questions: What is the rele-
vance of ICTs to the daily lives of older adults? What are the common ICTs appli-
cations in older adults’ lives? Which factors influence the acceptance of different types
of ICTs for aging in place by older adults with normal health status? What are older
adults concerned with when using different innovations of ICTs? This review will try to
shed light on all these issues.
2 Methods
2.1 Literature Search Strategy
Four multi-disciplinary databases (Scopus, ProQuest, EBSCOHOST, Science Direct)
were searched using a combination of three groups of key-words regarding age,
acceptance and ICTs respectively: (1) ‘older adults’ OR ‘older people’ OR ‘elderly’
OR ‘aging’, subjected to ‘Title’; (2) ‘acceptance’ OR ‘adoption’, subjected to
‘Title/Abstract/Keywords’; (3) ‘information technology’ OR ‘ICTs’ OR ‘digital’ OR
‘electronics’ OR ‘computer’ OR ‘mobile phone’ OR ‘internet’ OR ‘e-health care’
OR ‘online service’ OR ‘home monitoring’, subjected to ‘Title/Abstract/Keywords’.
Since technologies and social life changed so fast in recent years, this review will only
focus on the batch of relatively new studies in recent ten years from 2004–2014/2015.
A scientific selection process was developed by different kinds of exclusive and inclusive
principles as shown in Fig. 1.
Acceptance of ICTs by Older Adults: A Review of Recent Studies 241
Initial retrieval from 4 Scopus ProQuest Science EBSCOhost

multi-disciplinary databases, Direct
cut-off: 2004-2015 18 228 420
450
Select peer reviewed

articles which supply full 13 92 291 104
text in English
Topics exclusion 5 32 26 26
Abstract exclusion 3 15 8 10
De-duplication 2 11 8 8
Fig. 1. Flow diagram of articles selection process
2.2 Article Extraction

In order to extract the appropriate and valid articles in this review, a set of inclusion
principles regarding ‘Topic exclusion’ and ‘Abstract exclusion’ were developed as
shown in Table 1.
Table 1. Criteria for inclusion in review

Criteria
1. The topic of an article should be within the range of ‘ICTs acceptance’, those topics on
‘disease’, ‘cognitive/physical rehabilitation’, ‘child’, ‘women’, ‘social capital’, etc. were
excluded
2. After reading abstracts, review articles and narrative articles were excluded. Moreover, only
those exploring or confirming acceptance factors and concerns were retained
3. Target technologies should be within the range of ICTs-related computerized or
internet-based devices or systems which will generate data transmission
4. Participants in an empirical study should be older than 55 and with a normal health status
physically and mentally
Finally, 29 valid papers were retained in total including qualitative methods

(e.g. interviews, focus groups, contextual observations, diaries), quantitative methods
(e.g. surveys, experiments) and mixed method.
242 Q. Ma et al.
3 Results
3.1 Characteristics of Reviewed Articles
The 29 articles were examined for exploring the factors that influence the willingness
of older adults to use ICTs for aging in place, as well as their perceptions and
expectations of different types of technologies. It was noted that the studies focused on
a broad range of applications in our daily lives. Further, these interventions can be
reasonably assigned into four specific applicable domains: intelligent monitoring,
health care delivery, online services and social communication. Besides, some studies
worked on this topic from a general point of view without addressing to a specific
category of technology. Among these articles there were 12 qualitative studies, 13
quantitative studies, and four mixed studies respectively. General instruments such as
cross-sectional questionnaire survey, face-to-face interview, experimental study, focus
group, scenario study, ethnographical study, etc. were employed. There were more
developed countries and central cities than developing countries and frontier areas in
exploring the issue of older adults’ acceptance towards ICTs. More studies appeared in
recent five years from 2011 to 2015. The main characteristics of the 29 literatures are
shown in Table 2.
3.2 Usage of ICTs by Older Adults

Older adults reported using a wide range of technology in their everyday lives and cited
efficiency, making life easier, and communication as reasons for the use of technology.
General ICT devices and services that are adopted by older users include mobile phone,
desktop computer, Internet, electronic commerce, portable computer or mini-computer,
and various kinds of computer/smartphone applications and internet applications. Apart
from communicating with family members, friends, and health care providers, and
dealing with daily routines, ICTs can be applied in various innovative fields in people’s
daily life, such as e-services, smart-home, tele-medicine, ambient intelligence moni-
toring, robots, etc. Literatures in this review covered majority of ICTs innovations
which were classified into intelligent monitoring, health care delivery, online services
and social communications, as shown in Table 2. ICTs are now highly relevant with
older adults’ daily life at home, work and health care environment [33]. Since work life
is extending, to remain active, competitive, and useful in the workforce, older adults
must use and learn to use basic digital technologies in the information era. Many older
adults prefer to remain in their own home, the majority of their activities occur within
the home environment. ICTs can support many home-based tasks, e.g., gathering
information, safety and security monitoring of older adults at home, etc. More ICT
applications will be brought into older adults’ home environment and it is a positive
trend for older adults to use ICTs in home. Besides, ICTs have the potential to assist in
monitoring and maintaining health as well as managing health conditions and diseases,
especially in facilitating cost-effective care [34].
Table 2. Characteristics of reviewed articles

ICTs domains Ref. Application Study design
Method Measurement Sample Country
Intelligent [6] Ambient intelligence Qualitative Individual interview 18 USA
monitoring technologies
[7] Wireless sensor network Qualitative Focus group 13 Australia
(WSN)
[8] Communication and Qualitative Scenario study 9 USA
monitoring
technology
[9] Medical monitoring Quantitative Questionnaire 127 USA
[10] Home-based monitoring Qualitative Focus group 64 USA
[11] Smart home Qualitative Focus group 14 USA
information-based
technologies
[12] Remote patient Quantitative Questionnaire 14 USA
monitoring
Health care [13] Medical assistive Mixed Focus group, 104 Germany
delivery technologies Questionnaire
[14] Health-related ICTs Mixed Questionnaire 123 USA
Israel
[15] Electronic health record Qualitative Questionnaire 372 USA
(her) systems
[16] Telehealth kiosk Qualitative Focus group 12 USA
[17] Mobile health service Quantitative Questionnaire 204 China
Online services [18] E-Government Quantitative Questionnaire 146 Gambia
In-depth
interview
[19] Online shopping Quantitative Questionnaire 574 Taiwan
Social [1] E-mail Qualitative Ethnographical study 200 Spain
communication [20] E-mail Quantitative Questionnaire 460 USA
[21] Mobile data services Quantitative Questionnaire 266 Hong
(MDS) Kong
[22] Telephone voice menu Mixed Questionnaire, 27 USA
systems Experimental
study
Internet & [2] Internet Quantitative Questionnaire 150 Germany
Computer [23] Internet Quantitative Questionnaire 374 China
[24] Internet Quantitative Questionnaire 592 UK
[25] Computer Quantitative Questionnaire 52 Germany
General [26] Technology Mixed Socioeconomic 100 Brazil
technology survey,
Questionnaire
[27] Technology in home, Qualitative Focus group 113 USA
work and healthcare
[28] Technology Qualitative Daily workbook 6 USA
questions
[29] ICTs Qualitative Focus group, 81 Ireland
Individual
interview
[30] Information technology Quantitative Questionnaire 233 China
[31] Gerontechnology Quantitative Questionnaire, 1012 Hong
Face-to-face Kong
interview
[32] ICTs Qualitative Focus group, 7 Spain
Questionnaire
244 Q. Ma et al.
3.3 Determinants of ICTs Acceptance

Research around technology acceptance and usage among older adults has now
received increasing attention over time, especially in the developed countries such as
the United States, Japan, and The Netherlands. Majority of the studies towards tech-
nology acceptance factors for aging in place were in the pre-implementation stage.
Various factors were explored by prior researchers in different contexts. These factors
can be basically categorized into Perceived Benefits of Use (i.e., perceived impact on
life, perceived usefulness, needs satisfaction, perceived benefits, perceived conve-
nience), Subjective Norm (i.e., children/family’s influence, caregivers’ influence, social
influence), Perceived Behavior Control (i.e., self-efficacy, anxiety, facilitating condi-
tion, support availability), Perceived Usability (i.e., perceived ease of use, age-centered
interface, system reliability), Affections, and Socio-demographic mediators (i.e., gen-
der, age, education, income, health and post experience), as shown in Table 3.
Different structural models based on Technology Acceptance Model (TAM) [35],
Unified Theory of Acceptance and Use of Technology (UTAUT) [3], and the Theory of
Planned Behavior (TPB) [36]) were built according to the causal dependencies among
the potential factors. Chen and Chan [31] built a gerontechnology acceptance model
called “STAM” among older Hong Kong Chinese. The results showed that individual
attributes including age, gender, education, self-efficacy and anxiety, and health and
ability characteristics, as well as facilitating conditions explicitly and directly affected
technology acceptance. Besides, Heart & Kalderon [14] explored older adults’ adoption
of health-related ICTs through examination of TPB in the context of computer use. The
result indicated that perceived behavioral control could significantly affect intention to
use information and communication technology. Whether older adults determine to use
technology also depends on their perceived needs or benefits, it is the most frequently
mentioned factor overall [16]. Non-use of computers can be attributed to their low
relevance and ‘relative advantage’ to older adults [37] as older adults like to adopt and
use technologies only if the value and personal relevance is clear [28]. Generally, older
adults report that they care much more about the benefits they gain from ICTs than the
costs on ICTs [22].
Furthermore, more external factors such as family and social influence and product
usability were identified as important determinants towards various kinds of technology
acceptance. Older adults’ children, friends and professional caregivers may positively
or negatively influence their acceptance [10, 11, 28]. The longer older adults have used
the technology, the more they perceived those people who are important to them would
want them to use it [12]. From a human factors and ergonomics view, most studies
presented evidences for the common suggested physiological and psychological rea-
sons behind older adults’ lower levels of use of ICTs (e.g., poorer vision, memory, and
dexterity) [38]. Older adults seemed to tolerate some complexity, but it should not be
more than they could handle after learning [39], perceived usability was found to be
important to the adoption and long-term use of the technology- the technology should
be reliable, controllable, simple to use and tailored to users [7, 16]. Other than those
modeling-based determinants, another determinant that can be extracted from the
emotional dimensions of older adults is affections. Anxious or emotional reactions are
expressed by older adults when they use computers or money-related technological
services. Moreover, it was found that there was generally a negative prejudice or some
discrimination attached to the use of assistive health technology like emergency alarm
services [40]. Socio-demographics were shown as better predictors of gerontechnology
usage behavior than the conventionally used attitudinal factors (usefulness and ease
of use) [31]. Key socio-demographic variables in technology adoption were extracted
as gender, age, income, and education [2]. Socio-demographic variables can further
increase the power of technology acceptance model to determine whether older adults
ultimately adopt the ICTs and to what extent.
Table 3. Summary of acceptance factors regarding ICTs

Themes of determinants Items References
Perceived benefits of use (PBoU) Perceived impact on life [7]
Perceived usefulness [10, 22–24]
Needs satisfaction [11, 30]
Perceived benefits [27]
Perceived convenience [27]
Subjective Norm (SN) Children’s/families’ influence [12, 28]
Social influence [8, 12, 15, 19]
Subjective norm [21, 23]
Perceived Behavior Control (PBC) Self-efficacy [14, 31]
Facilitating condition [14, 20, 25, 31]
Anxiety [7, 17, 31]
Support availability [30, 32]
Perceived Usability (PU) Perceived ease of use [17, 21, 23]
Age-centered interface [1, 15, 16]
Perceived usability [30]
System reliability [7, 27]
Socio-demographic mediators Gender [2, 9, 24, 26, 31]
Age [2, 9, 31]
Education [2, 31]
Income [2]
Marital status [14]
Health [1, 9, 14, 31]
Experience [8, 29]
4 Discussions
4.1 Usefulness and Findings

This review’s strength lies in its literature set which includes most recent studies on
older adults’ acceptance of ICTs innovations, and it is more holistic since it gathered
articles from four different multi-disciplinary databases (Scopus, ProQuest, Science
Direct, EBSCOhost databases), involving studies from fields of ergonomics, sociology,
246 Q. Ma et al.
psychology, gerontology, health, etc. Besides, the review classified ICTs innovations
adopted in older adults’ lives (home/work/health care) into several groups, thereby
highlighted that the development of recent ICTs innovations for older adults is clearly
focused on intelligent monitoring or assistive products/services/systems, and indicated
that the trend of adopting home-based information technology innovations is inevitable
among older adults. Acceptance determinants (including mediators) were clearly dis-
tinguished in this review. Since determinants may promote users’ acceptance, the
identified determinants may contribute more on later academic studies.
From the review, word strings like ‘needs’, ‘benefits’, and ‘relevance’ were fre-
quently referred in most literatures. It revealed that older adults cares most about the
benefits they can gain from ICTs innovations instead of extended features. Besides,
‘cost’ or ‘finance’ were mentioned as concerns in most literatures, older adults do
report a heavy concern on the monthly service cost of ICTs and they hope that someone
or government can afford a part of the expense. However, several studies also indicated
that older adults choose to adopt the technology product/service as long as they need it
or the benefits they get are worth the costs. Another significant aspect is on the
usability; older adults reported many complaints on the obstacles when learning to use
technologies due to health and ability impairments compared with younger people.
Finally, older adults reported that they need human assistance or some other kinds of
facilitations when using ICTs innovations.
4.2 Limitations and Future Work

However, this review should be used under the premise that it has three critical limi-
tations. First, the extraction criteria of literatures do not include some important per-
sonal attributes of participants such as older person’s past experiences and their living
arrangements, the influences of these attributes should not be ignored sometimes.
Second, the review has now classified several groups of ICTs innovations, it would be
better if the study continued to review acceptance factors and concerns specific to each
type of ICTs application respectively rather than just gave a general idea on all ICTs
innovations. Third, as technology and people’s living style developed quickly, there
should be a holistic comparison on the acceptance situation towards ICTs of older
adults in recent ten years and past decades, it will be a promising way to enlighten
researchers and practitioners studying this topic, and even predictions of the acceptance
towards ICTs by older adults in future can be seen in advance.
Meanwhile, some gaps were identified for future research in this review. Most of
prior studies identified various factors that influence the acceptance of information
technology. However, few studies identified the interrelationship of these factors and
few of them adapted these factors into established models such as TAM, UTAUT and
TPB to measure the acceptance of ICTs (or one kind of ICT device or service) by older
adults. Another important gap is that there are few studies focusing on the longitudinal
usage or acceptance of ICTs innovations. From a quantitative view, the ICTs accep-
tance model of older adults should be a dynamic one instead of a static one along with
usage period. More and more research attention is appealed to the understanding of
reasons of non-use of ICT by older adults. Now, it is time to explore promising tools to
facilitate older adults to adopt ICT devices and services more effectively. In addition to
aging-centered design, both the traditional and computer training programs need further
studies.
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An Appraisal-Based Approach to the Stigma
of Walker-Use
Andrew McNeill(&) and Lynne Coventry
PaCT Lab, Department of Psychology, Northumbria University,

Newcastle upon Tyne NE1 8ST, UK
{andrew.mcneill,lynne.coventry}@northumbria.ac.uk
Abstract. Walker-use among older adults is often avoided because of the

stigma of using one. Drawing on the appraisal theory of stress, we argue that
stigma associated with walker-use is subject to various cognitive appraisals that
affect whether the user sees the walker as stigmatizing and the extent to which
they can cope with that stigma. We followed a participatory design approach to
involve older adults in the design of an intelligent walker. One of the activities
was to conduct focus groups to explore the role of the aesthetic design of the
product in acceptance and use of such walkers. Qualitative analysis of these
focus groups provides data explaining the ways in which potential users assess
stigma and coping resources. We emphasise that while better design of walkers
is important, tackling the self-stigma of users and increasing their ability to cope
with using one is equally important.
Keywords: Psychology and cognition User acceptance Design
1 Introduction
One reason why some older adults do not use assistive technology such as walkers is
stigma [1]: a “devalued identity” associated with their use [2]. When an older adult
considers using assistive technology such as walkers, they have to deal with the
potential of stigma from others who see the walker as a sign that they are old and
disabled. People might talk down to them, treat them as being less mentally capable
and exclude them from certain activities. The identity of being an “old person” is
widely perceived as undesirable and this affects many of the ways in which older adults
behave [3, 4]. Sometimes older adults will even avoid the use of blankets [3] or avoid
reporting falls [4] because they fear being identified as “old”. Others avoid using
assistive walking aids like canes because of stigma [5, 6]. Devices like walkers are
signs that a person is old and these can convey a stigmatised identity. For this reason,
older adults sometimes utilise compensatory strategies to avoid stigma such as using
umbrellas [7] or shopping trolleys [8, 9] as covert walking support. Such devices
provide support for the user but do not evoke the stigma of being an “old person”.
While stigma is a key reason why older adults may avoid using assistive tech-
nology, it is not always the case that older people are treated negatively. Sometimes
attitudes towards older people can be described as “benevolent ageism” [10] which is a
tendency to “over-help” older adults. Stigma associated with aging is also internal as

DOI: 10.1007/978-3-319-20892-3_25
An Appraisal-Based Approach to the Stigma of Walker-Use 251
we are prejudiced not merely against others, but also our future selves [11]. Older
adults may fear their future self who uses assistive devices and thus avoid such
technology. Rather than simply targeting the wider population to decrease stigma, older
adults must confront their own negative attitudes.
When older adults face stigma due to using a walker, whether external or internal,
this stigma can be considered as a potential “stressor” [12]. They may fear using the
walker because it gives them a negative self-image [13] or because they fear what other
people will do or say to them [5]. This fear can lead to stress. However, the effect of
this stressor is not the same for all people; different people react to stress differently via
different coping mechanisms. According to the appraisal theory of stress [14], a
stressful encounter is managed by ascertaining the meaning of the encounter (primary
appraisal) and the availability of coping mechanisms (secondary appraisal). The coping
strategies can either be problem-focused where the stressor is removed through altering
the situation or emotion-focused where the stressor is reduced through regulating
emotions. In the case of walkers, primary appraisal will evaluate whether using a
walker is stressful and secondary appraisal will provide coping mechanisms if it is
perceived as stressful. Those coping mechanisms could take the form of a problem-
focused strategy (avoiding using the walker) or an emotion-focused strategy (choosing
to focus on the benefits of use). These different coping strategies are apparent when
users of assistive technologies negotiate their reliance on them by employing various
strategies such as resignation, but limiting use or focusing on the benefits of using it
[15].
Multiple strategies can be used to cope with the stigma-stress of using the device
and this means that even when stigma does exist, it can be coped with and overcome.
One possible way to decrease the stigmatizing effect of assistive technology is to
increase our use of universal design principles. One of the key principles of universal
design is the principle of equitable use which states that the design should be “useful
and marketable to people with diverse abilities” [16]. This suggests that the service
should be provided in the same way for all users wherever possible and should avoid
segregating and potentially stigmatising users. This principle also emphasises the role
of designs which are appealing to everyone. The most quoted example of this is the
OXO good grips kitchen equipment, originally designed to be easier to grip by people
with arthritis, but the design is sought after by many.
A key concept of universal design, is to provide accessibility without requiring an
adaptation or assistive technology, by integrating assistive features unnoticed into the
design. By its very nature, it should remove any stigma associated as the same design is
used by everyone. Figure 1 illustrates how as abilities lessen, inclusive design has a
role to play in increasing the number of people who still can use a product, by
increasing the depth of the bottom layer of the pyramid. For instance, e-books with
backlights can be seen as an inclusive design, providing greater contrast and font size
without having to request an adapted version of a book. More advanced versions can
even provide access to audio books, again not only something visually impaired people
would want, but with celebrity narrators they are desirable to a wider audience. An
alternative approach is to create adaptations which are not perceived as assistive,
therefore not impacting self-efficacy, or stigma. As with the example of using a
shopping trolley as a walking support, the alternative role of carrying shopping is
252 A. McNeill and L. Coventry
emphasized. The final approach is to explore if the design of adapted environments and
assistive technologies can be done in such a way that they are evaluated as socially
acceptable – even desirable. We have seen such a shift in the design of eyeglasses, from
undesirable, stigmatizing and medical to designer-led and aspirational.
Fig. 1. Changing Abilities and Inclusive Design
Alternatively, a kettle may be too heavy for a frail, older adult to lift and be
dangerous. We could suggest that the older adult requires assistance and design an
assistive aid that will support them in the lifting task but this clearly highlights their
declining abilities and may lead to self-stigmatising. An alternative would be to suggest
a smaller kettle and emphasize the positive effect on the environment and fuel bills
rather than the lack of lifting ability. This may inadvertently trigger feelings of lone-
liness. Alternatively we could suggest the newer designs that remove the need to lift the
kettle altogether by pouring the hot water directly into the cup without lifting. These
designs again are more environmentally friendly, only heating water as it is poured,
allow multiple cups and remove lifting of more than a cupful altogether (Fig. 2).
a b c d
Fig. 2. Presenting adapted technology as aspirational technology
The question is whether or not it possible to make mobility aids more desirable?
How can we design walking aids that everyone would be happy to use? An example is
the design of Nordic Ski poles, which are widely viewed as more acceptable than a
standard medical issue walking stick. They are promoted as an exercise aid rather than
as an assistive technology. We also see more elaborate designs of walking sticks,
turning them into desirable objects.
Exploring different forms of appraisal allows us to understand individual differ-

ences in response to the use of walkers and why not all older adults find using a walker
stigmatising. By understanding why some people do not find walker-use stigmatising
and how others successfully use coping mechanisms, suggestions can be made for how
to assist other older adults to be more willing to use walkers. We conducted this study
as part of our work on DALi (Devices for Assisted Living) [9, 17] where we are
working with technology partners to design an intelligent walker which supports older
adults in large unfamiliar public spaces such as shopping centres and hospitals. Our
ultimate goal is to create a robotic support that is both functional and desirable. For
people who require assistance, it will operate as a walking and navigation aid and help
them to physically carry their shopping. Others will simply use it as a type of desirable
“personal assistance”. Consequently, we were eager to explore how to make such a
product less stigmatizing and more appealing. Being able to achieve this is important
because the development of acceptable walkers and ways to encourage older adults to
accept and use walkers will encourage users who may fear going outdoors [18] to
become more active. Becoming more mobile is associated with a range of physical,
psychological and social benefits which will enhance users’ lives [19].
2 Method
2.1 Data Collection

Five focus groups were held with groups recruited via a database of older participants.
Each group contained 4–7 participants. These focus groups took the form of tea parties
[17] which are less formal focus groups that include a time for tea and cakes. The less
formal nature of these groups has been found to aid more open discussion.
Semi-structured questioning was used, supplemented by use of images of walkers
to elicit views. While it can be difficult for participants to talk about what exactly makes
a walker’s appearance stigmatizing, discussing photographs provides opportunities for
specific designs to be critiqued. We specifically used images that were not created
within the project and emphasized to participants that these were not our designs and to
feel free to critique them honestly. We felt it was essential for participants to not be
“nice to the designers”, a situation we have encountered in other projects. The sessions
were recorded by both audio and video recorders.
2.2 Analytic Approach

The transcripts were coded using “template analysis” [20] which stresses the impor-
tance of developing an hierarchical structure of themes. The approach allows for a
priori categories to be used (e.g. primary and secondary appraisal). The transcripts were
read and coded to answer the research question, “What factors influence stigma
associated with walker use?” These codes were then grouped into two categories:
primary appraisal and secondary appraisal.
3 Analysis
Table 1 provides an overview of the two forms of appraisal. Primary appraisal relates to
whether the experience is perceived as stressful/stigmatizing and secondary appraisal
relates to the coping strategies that can be used if it is perceived as stressful/stigmatizing.
Occasionally themes overlapped both forms of appraisal.
Table 1. Table of main themes from qualitative analysis
Appearance of walker Problem focussed
Secondary appraisal
Walker as extension of self Ability to customize
Primary appraisal
Perception of function and Social support

identity Cognition focused
Attention-drawing Cognitive emphasis on benefits
Attractive design Necessity
Social acceptability Age-related apathy
Self-esteem Time reduces stigma
3.1 Primary Appraisal

Appearance of Walker
Walker as Extension of Self. The appearance of the walker is important as it is linked to
the person using it, - if it looks bad, the user looks bad. One participant compared the
use of a walker to clothing and accessories: “It’s almost an extension of your dress
really, it’s an extension of your external appearance, it’s another appendage, like a
watch …”
If a walker is unattractive, this causes the user to look bad. On the other hand, an
attractively designed walker can offer a user the same positive benefits as an attractive
watch or attractive clothing. For this reason, some users also talked about the need to
have gender-relevant designs. Walkers would be a positive benefit only if their
appearance matched the gender of the user.
Perception of Function and Identity. A device that is designed for people with dis-
abilities confers on the user the identity of “disabled”. On the other hand, when par-
ticipants discussed various devices, the devices that were associated with positive
functions (i.e. those that stressed the ability of the user) often led them to confer a
positive identity on the user. One participant noted that the use of racing wheelchairs is
not associated with a negative identity: “If you look at somebody in a racing wheel-
chair, particularly a young person in a racing wheelchair, people don’t look at them
with pity do they?”
This fear of being “pitied” is interesting insofar as the user is not necessarily
concerned about being maltreated as much as being perceived as less able than others.
This is the essence of stigma which can be described as a “devalued social identity”
[21]. Nevertheless, it is important to note that the wheelchair per se is not stigmatizing
and that when it is constructed in a way to display the ability of the user, it avoids
giving the user a devalued social identity. When participants were shown a range of
designs, they preferred the designs that stressed positive attributes of the user: “It’s got
impact you see hasn’t it? It gets away from the idea of disability, it gets away from…
It’s got more of the idea of being “with it”.
In the design mentioned here (Fig. 3) the participant perceives that the design
avoids connoting disability and instead confers upon the user the positive attribute of
being “with it”. However, we should not assume that all users react in the same way
and for some, the same walker was perceived as bulky and unattractive. The notion of
primary appraisal makes sense of this because some users find the same product
identity-enhancing while others find it stigmatizing.
The participants often mentioned the idea that the design of walker communicates a
“message” to others. Some designs say negative things: “It says to me, very disabled
that one” (Fig. 4). Other designs, on the other hand, say positive things:
“It doesn’t shout disability it says, “I’m out shopping”” (Fig. 5).
Fig. 3. A design Fig. 4. Device perceived as Fig. 5. Shopper-walker hybrid

described as being “disabled”;
“with it”.
While the message conveyed is a functional one (shopping), this is inextricably

linked to identity because the activities performed often point to the identity of the
person performing them. Being a “shopper” is perceived as positive while being
“disabled” is negative.
People often arrive at their perception of function and identity by comparing the
device with pre-existing products. Thus, when a design looks like a “baby bouncer” it
is deemed inappropriate but when it looks like a golf cart it may be deemed suitable:
“A: In this form, it looks like a golf trolley; B: Or a wheelie bin! C: have your golf clubs in it! A:
Yea, I quite like that” (Fig. 5).
As the quote above demonstrates, different people may have quite different reac-
tions to the same device. For one the design is like a golf trolley whereas the other sees
it like a bin. One design that was particularly liked by participants was likened to a
scooter and participants said that they could pretend they were on a “Vespa or
Lambretta or something” (Fig. 7). The kind of comparisons people make therefore,
form the basis of whether they find the device stigmatizing.
Attention-Drawing. Generally, most participants preferred walkers which did not draw
attention to themselves. This attention can either be visual attention or attention caused
by the size of the walker. One participant talked about how he noticed a woman on his
bus struggling with the walker which was obstructing others and how it was embar-
rassing. Everyday incidents like this caused concern to participants about stigma. In the
more extreme examples of walking aids, the idea of attention is prominent:
“A: To be outside in that would be horrible! I mean, …B: you couldn’t miss it! C: no no! D:
you’d get people lining up to watch” (Fig. 6).
The idea of having people deliberately watching causes the participants discomfort.
Nevertheless, some participants feel at ease with being watched as long as it is for the
right reasons: “You are the one people are going to stare at. If they stare at you
because it’s funky, it’s different.”
In this context, the participant anticipates being stared at but would accept it if it
were because the walker is “funky”. While not all participants are comfortable with
attention, for some it is acceptable if it is positive.
Fig. 6. Hanging Fig. 7. A popular design; Fig. 8. Walker with model

walking aid;
Attractive Design. Designs which are unattractive can make the user feel stigmatized
or embarrassed:
“You could walk with it but you’d to have a bag over your head wouldn’t you.”
Even though this is a humorous quote, it belies a serious point. Users want to have
designs which do not draw unnecessary attention and make the user feel proud of their
walker. Not only do participants seek to have a product that is attractive for them, but
they want something that other people would like.
“It looks as though everybody would want one” (Fig. 7).
They also talk about being proud of the device if they took it outside and joked
about having brand names like “MacLaren” or “Ferrari” on it – labels typically
associated with prestigious and desirable products. A minor theme related to this was
the idea that the apparent cheapness of a device was something that created stigma.
Devices that appear to be more expensive are deemed more desirable and attractive.
Social Acceptability
Quite frequently, participants talked about how walkers would be more acceptable if
used by others including prominent individuals. One person said that if the Queen used
one, it would go a long way towards making their use more acceptable: “If the Queen
started to use a walker … it would become more acceptable”.
But it is not just prominent individuals that people look for when thinking about
walker-use. The way ordinary people use their walkers contributes to their assessment
of the walker. This became apparent when participants began discussing the models
using the walkers in the images. In some images, the models were perceived as
enhancing their impression of the walker: “The one that I got, which has a positive
outdoor looking lady on the top, influenced my opinion a lot” (Fig. 8).
Because the model in this instance was perceived as being “positive”, this con-
tributed to the participant’s sense that the walker was a positive thing. On the other
hand, when the model is associated with negative characteristics, this negatively
impacts their assessment of the walker: “See that image of somebody bent over with
their shoulders, it just ruins it.”
This means that the relationship between the walker and the person using it is not a
one-way relationship (i.e. the walker can make the user look good or bad by virtue of
its appearance) but a two-way one in which the user can also influence others’ per-
ceptions of the walker. People look to others who use walkers to make their appraisal of
whether the walker is a stigmatizing device.
Self-Esteem
By making the user feel old or dependent, the walker can be a source of stigma.
Nevertheless, being treated as an “old person” by others is something which some
participants enjoy while others dislike:
“[People] ask questions over your head or shout at you because they think you’re deaf. I think
it’s lovely! I love it […] you know, it doesn’t bother me one iota.”
This person apparently enjoys being treated as an older adult because many of the
ways in which this can occur are benevolent rather than malicious. She explained, for
example, that she enjoyed being allowed to join the front of the queue because she was
perceived as older. However, while this experience of “benevolent ageism” is per-
ceived as positive by some participants, others react against it. They talk about the
“danger that you will be treated as an old person” and link this to avoidance of walking
aids. One participant referred to her use of a wheeled shopping bag to carry her
groceries and even linked this to stigma:
“I used to have one of those [a shopper] before I had a car, and I must admit I did feel a bit
stigmatised because it felt like an old lady’s trolley”.
The participants felt that shoppers and walkers both have a similar appearance
sometimes. This is why the participant above refers to feeling “stigmatized” because
she felt her trolley attributed the identity of “old lady” to her. This devalued identity is
something that participants seek to avoid and while some people appreciate the
benevolent aspects of ageism, others prefer not to be perceived as “old” in any way.
3.2 Secondary Appraisal

If walker-use is stigmatizing in some way, this does not mean that it will necessarily be
avoided. Perceived stigma will be moderated by users’ coping strategies. These coping
strategies can be more problem focused or more cognition focused.
Problem-Focused
Ability to Customize. Some participants liked the idea of customizing their own
walker to reflect their personalities. By doing so, this offsets some stigma associated
with using a walker: “One with flowers on it? Perhaps like the walking sticks? You
could personalise them because that seems to be, people are much more creative now,
and that might appeal to people to be able to put different motifs on them, different
coloured seat covers or whatever you’ve got.” In this extract, participants suggest that
customizing walkers would help to make them more acceptable.
Social Support. Social support can be both a primary and secondary appraisal strategy.
If walker-use is common, this can encourage people to see them as devoid of stigma
(primary). And if people use the walker with others, this can diffuse the stigma (sec-
ondary). One design of a walking aid was quite robotic and eye-catching. Participants
talked about taking it into the city centre: “A: The first time you did it, you might get
some funny reactions; B: But if we were together…A: … If you took it out a few times
then people would get used to seeing it.”
The idea that being together would reduce the stigma associated with using it may
stem from a diffusion of the stigma. Alternatively, the collective use of the walker may
reflect identity dynamics whereby being associated with a social group provides a
coping mechanism to reduce stress/stigma [22].
Cognition/Emotion-Focused
Cognitive Emphasis on Benefits. While the use of a walker may seem stigmatizing,
users can use a coping strategy which stresses the benefits of using a walker. Partici-
pants talked about the benefits of being perceived as old at airports, in shops and on
public transport. For these participants, the walker functions as a sign to other people
that the user is elderly and implicitly invites benevolent age discrimination: “People
are very considerate of them, they do make room for them and they do help them onto
buses and they do, you know, it’s a sign to other people”.
This use of the device as a signal to other people is both a good thing and a bad
thing. For some users, the signaling that the user is old and dependent is limiting and
stigmatizing whereas for others, it provides the help they desire. While participants
recognize why some people do not like using walkers, they believe that persuading
others of the benefits can encourage their use: “I don’t know, well I do know why
people don’t want to use them, I do understand that but, if you could just persuade
them of the benefits of using them”.
The walker may be stigmatizing in some ways, but users can cognitively reappraise
what the reaction of other people means. Rather than perceiving it as a negative thing
(pity or patronization), they can frame it as something positive (help and support).
Necessity. Another cognitive strategy that people use is to see the use of the device as a
necessity. By being convinced of the need to use it, participants can outweigh the stigma
of even the most unattractive of devices. One device that was particularly unattractive and
conspicuous (Fig. 6) received unfavourable comments from many participants. Never-
theless, many also stressed that they would use it if it enabled them to perform tasks that
they could not otherwise perform. Again, another lady who remembered her time when
she could not walk and was bedridden said: “If it had been offered to me, if it was pink with
green spots and had feathers sticking out of it and it jangled like a tambourine, and they’d
said, “P, this will help you get on your feet”, I would have done it.” As she describes the
walker, she deliberately emphasizes the extent to which it could be stigmatizing (“pink
with green spots” with “feathers”) and stresses that in spite of this, necessity would
outweigh stigma. This coping strategy focuses on the need to use the walker and thus
reduces perception of the stigma (or concern with it).
Age-related apathy. On several occasions it was mentioned that in old-age there is less
concern about what other people think. There is an acknowledgement that stigma may
still be there, but it becomes irrelevant: “But do you find that as you get older, one of
the advantages is that you don’t give a damn what anyone else thinks?” This con-
struction of the self as someone who does not care about what other people think allows
the participants to ignore any stigma that may be present.
Time Reduces Stigma. Sometimes when participants saw images of walkers, they
acknowledged that the walker may be initially stigmatizing but also believed that over
time, the stigma would decrease. This was not used to argue that the participant would
only use one when the stigma had decreased in the future, but the belief that the stigma
would decrease in the future gave them reason to consider using it in the present:
“A: I think it’s an amazing piece of equipment [(Fig. 6)…] but if we’re talking about walking
round Eldon Square [shopping centre]; B: Of course people would get used to seeing them; A:
There’s that point!; B: The first time you saw it you would think, “What on earth’s that?” But if
you kept seeing it you would get used to it.”
Participants acknowledge that there may be initial negative reactions but offset this
with the belief that this type of reaction will fade over time. Beliefs about what the
future will be like can provide a coping mechanism for enduring stigma in the present.
4 Discussion
Stigma associated with walker use is a subjective issue and influenced by appraisal of
various issues. Seeing stigma through the eyes of the stress appraisal literature [21]
allows us to argue that walkers are not stigmatizing per se but must be appraised as
such by the potential users. While this may mean that they avoid using them, this study
also argues that even the perception of stigma is not sufficient to discourage use if the
user can mobilise coping strategies. This study has explored a range of ways in which
people evaluate the use of walkers as stressful or not and if so, how they anticipate
coping with using one.
This has relevance insofar as much research emphasizes developing more aes-
thetically pleasing devices or targeting problem attitudes in wider society [1]. We
concur with this but argue that insufficient attention has been paid to helping the users
come to terms with technology use. The range of strategies that can be used to either
perceive a device as lacking in stigma or cope with stigma provide insight into
encouraging the uptake of walkers. Older adults need help to see the benefits of using a
walker. Furthermore, if the problem that many older adults face is that of self-stigma,
their own stigmatization of walker-users, then changing older adult’s appraisal of
walkers is essential.
Our work suggests that more attractive designs, more gender relevance, hidden
assistance and more positive societal attitudes are not important but equally we
emphasise the importance of seeing stigma as an appraisal issue and then helping
potential walker-users come to see their walker in a positive light.
5 Conclusion
We believe that this study addresses some important questions about psychosocial
influences on mobility and well-being in older adults. These new results also have
important clinical implications, highlighting the need to develop intervention strategies
that deal with potential psychosocial barriers to mobility, such as fear of stigmatisation.
This will help to ensure that mobility interventions, like the provision of mobility aids,
do not fail at the outset as a result of user avoidance, but enable aging adults to have the
best possible quality of life. It also highlights the need to carefully consider how design
might influence older adults’ perceptions of themselves and their abilities. Our work
emphasizes the importance of using project independent stimuli to evoke genuine
evaluation from participants – good and bad. The ultimate goal is to design assistive
technology that is aspirational not stigmatizing.
Acknowledgements. This research was funded by EC Grant Agreement No 288917.
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Perceptions of Computer System Usefulness:
Insights for Design from Experienced
Older Users
Tracy L. Mitzner1(&), Neil Charness2, and Wendy A. Rogers1

1
Georgia Institute of Technology,
Atlanta, GA, USA
[email protected]
2
Florida State University,
Tallahassee, FL, USA
Abstract. Computer systems have the potential to assist older adults by sup-
porting independence, enhancing social communication, and enabling health-
care activities. Yet older adults’ adoption rates continue to lag behind younger
and middle-aged adults. We report data from 249 older adult computer users
(65–93 years of age) that identify the details of their perceptions of computer
usefulness for a range of everyday activities. Participants rated the importance of
activities to their quality of life and the usefulness of current computer systems
for supporting those activities. These experienced computer users indicated that
computers were meeting their needs for some activities (e.g., social communi-
cation, games) but not for other activities (e.g., calendaring, healthcare, recre-
ation and learning). Our data provide guidance for (a) introducing the potential
of computer systems to current non-users and (b) designing systems targeted to
meet the needs of older adults and enhancing computing functionality for them.
Keywords: Technology Older adults Adoption Perceived usefulness

Perceived ease of use
1 Introduction
Computers systems, from desktop computers to tablets and smart phones, can assist
with many tasks of daily life and provide users with the ability to connect with people,
information, and resources in the world without having to leave their home. Particularly
for older adults, there is much potential for computer systems to benefit their lives in
tangible ways such as social communication [1], access to health and other information
[2], and support for hobbies and leisure activities [3].
The potential for computer systems to support older adults is particularly com-
pelling in light of current demographic trends. Across the globe, the number of people
60 years or over is expected to more than double, from 841 million people in 2013 to
more than 2 billion in 2050 [4]. Such changing demographic distributions must be
considered in the context of computer technology development. Helping older adults
remain independent as long as possible could minimize use of costly long-term care
resources. Older adults also value being independent rather than relying on others for
DOI: 10.1007/978-3-319-20892-3_26
Perceptions of Computer System Usefulness 263
daily life tasks [5]. Computer systems that meet older adults needs could facilitate their
independence and, in doing so, reduce their need to depend on others.
Despite the potential of computer systems, older adults (e.g., 65+) continue to
underutilize them relative to other age groups. The latest findings from the Pew
Research Center show that 97 % of those 18–29 years of age and 93 % of those 30–49
years of age report using the Internet, compared 88 % of those 50–64 years of age, but
only 57 % of those 65 and older [6]. Although the Pew data reflect U.S. trends, similar
trends have been noted in other industrialized countries [7].
Research has pointed to characteristics of the user, as well as of the interface of the
technology to explain older adults’ underutilization of computer systems. Older adults
are less likely to have the prerequisite skills, attitudes, and experience as compared to
younger adults. In a sample of 1,204 adults (18–91 years of age) Czaja, Charness, Fisk,
and colleagues (2006) found that age, cognitive ability (i.e., fluid intelligence), eth-
nicity, computer anxiety, and education predicted computer experience. Gender, edu-
cation, cognitive ability (i.e., fluid and crystallized intelligence), computer anxiety, and
age predicted breadth of computer use [8]. Education, ethnicity, cognitive ability (i.e.,
fluid and crystallized intelligence), computer anxiety, and age predicted Internet
experience. Furthermore, older adults typically have less general technology experience
compared to younger adults [1], and that general technology experience is predictive of
computer and Internet attitudinal acceptance [9]. Moreover, interface design issues
have been noted as potential barriers for older users [10], especially those with limited
technology experience [1].
Beyond experience and usability issues, it is possible that older adult non-users do
not perceive computer systems as useful for supporting the tasks and activities that are
important to them. Indeed, an AARP poll of adults 50 years of age and older found that
71 % of non-Internet users were not interested in learning to use the internet; 47 % of
those respondents did not want to learn how to use the Internet because they were not
interested in the Internet all together [11]. Perception of usefulness is a strong predictor
of older adults’ technology use in a variety of contexts [3, 12]. In fact, the absence of
benefits may be a stronger influence than the presence of costs when predicting the
non-acceptance of a new technology. That is, if older adults perceive a technology to
provide many benefits they may accept a new technology despite associated costs such
as effort, expenses, or lack of skills [13]. Older adult non-users may not recognize the
potential benefits of computer systems for their lives and this perception cannot be
assessed from prior research that focused on usage patterns.
A goal for the present study was to assess perceptions of Internet usefulness of
older adults who are experienced computer users. These data provide guidance for
introduction, deployment, and training of non-users who represent nearly half of the
older adult population in developed countries and a much higher percentage elsewhere.
Knowing what other older adults find useful about the Internet might motivate non-user
older adults to learn themselves. Alternatively, understanding what older adult users do
not find useful can provide direction for design and instruction to computer developers,
and provide insights about lack of awareness or understanding of utility. These findings
have relevance to a wide range of current computer systems and software, including
tablet, smart phone, and wearable applications, and also provide insight into the
potential for future technologies, in terms of content and functionality.
264 T.L. Mitzner et al.
2 Overview of Study
The Pew Research Center assessment of Internet use [14] is based on respondents
saying yes to at least one of the following three questions: “Do you use the Internet, at
least occasionally?”, “Do you send or receive email, at least occasionally?” or “Do you
access the Internet on a cell phone, tablet or other mobile handheld device, at least
occasionally?” The Pew data provide a valuable broad assessment of Internet use but
much less depth regarding specific activities and preferences. Our goal was to garner
in-depth information about the perception of usefulness for using the computer for a
wide range of activities. We queried a large sample of older adult computer users about
the importance of a range of activities to their quality of life (i.e., personal relevance),
and assessed whether computers were useful to them in accomplishing these activities.
The activities where there was a match between importance and usefulness represent
target areas wherein non-users might find computers to be useful to them (and hence be
more motivated to learn). The activities where there was a mismatch between impor-
tance and usefulness represent opportunities for designers: the activity is important but
yet the older adults did not find the computer to be helpful to them.
3 Method
3.1 Participants
We mailed questionnaires to 662 older adults who were part of the databases main-
tained by the Human Factors and Aging Laboratory at the Georgia Institute of Tech-
nology (Atlanta, Georgia) and the Laboratory of Dr. Neil Charness at Florida State
University (Tallahassee, Florida). A total of 321 completed questionnaires were
returned (15 were returned as undeliverable) which translates to a return rate of 50 %.
Of the questionnaires returned, 249 were completed by older adults (65 and older) who
reported themselves to be computer users. In this report we have only included these
249 respondents. The age range of these respondents who were computer users was
65–93 (M = 75, SD = 5.79). Note that the sample was generally healthy (84 % reported
good to excellent health), well-educated (81 % reported completing at least some
college), and living independently (89 % reported living in a house/apartment).
3.2 Materials
We developed the 381-item Computer Preference & Usage Questionnaire (CPU-Q);
additional details are also provided in Mitzner et al. (2010) [3]. The CPU-Q includes:
1. Background & Health Information - gender, age, education, marital status, race,
ethnicity, housing, income, occupation, general health, health satisfaction, vision,
hearing, and limitations related to sitting, using hands, and reading.
2. General Importance of Activities - perceptions of the importance of various tasks in
daily life using a five point Likert-type scale with a neutral point (not at all
important to very important). The tasks and activities this paper focuses on are
social communication (e.g., communicating with family and friends; sending or

receiving photos), health-related (e.g., communicating with health care profes-
sionals; researching symptoms and illnesses), calendar tasks (e.g., creating
appointment reminders, tracking events with a calendar), and recreation and
learning (e.g., travel directions, learning new information), and games (e.g., soli-
taire, bridge).
3. Technology Experience - 17 items assessing frequency of use for a wide range of
technologies (answering machine, ATM, electronic book reader, cell phone) and 3
items assessing computer/Internet use, including frequency and duration.
4. Potential for Computers/Internet to Support General Activities - perceptions of
usefulness of computers in assisting with the same tasks and activities included in
the General Importance of Activities section, also using a six point Likert-type scale
with a neutral point (not at all useful to very useful).
5. Attitudes towards a Computer System Designed for Older Adults - perceptions of
the importance for an ideal system to support different activities. Participants were
instructed to imagine that they had been given a computer system developed spe-
cifically for use by older adults, along with the appropriate personalized training for
its use. The description was based on a system used in a randomized clinical trial
designed to assess the impact of a computer intervention on the well-being of
seniors with minimal computer experience (ClinicalTrials.gov Identifier:
NCT01497613) [15, 16].
3.3 Procedure
Questionnaires were mailed to participants, along with a postage-paid envelope to
return it once it was completed. This was a lengthy survey (47 pages) – participants
were instructed as follows: “We expect this questionnaire to take 45 to 60 min to
complete. At your convenience, please find a quiet area and time when you will have
about an hour free from interruption to complete this questionnaire.”
4 Results
For the goals of the current paper, the questionnaire responses were reviewed with the
following goals in mind: (a) assess computer and Internet experience of the older adult
computer users, and (b) identify activities that were important to them for which they
found the computer to be useful as well as activities that were important but they did
not find the computer to be useful. The data are descriptive but they represent a large
sample and provide guidance for deployment, training, and design.
4.1 Computer and Internet Experience

Participants were included if they answered yes to the question “Do you ever use a
computer and/or the Internet?” Most respondents (72 %) reported using the computer
and/or Internet at least 5 h per week and most (89 %) reported having used it for at least
5 years. Thus, this sample represents a group of experienced older adult computer
users.
4.2 Importance of Activities and Perceptions about the Usefulness

of Perceptions of Current Computers
We queried participants about two aspects of a variety of tasks and activities. We
asked, “For each task and activities listed in the table below, please indicate how
important they are to your quality of life.” Then, in a later section of the questionnaire
we had the same list of tasks but the question was: “How useful are computers and the
Internet for supporting the following tasks and activities?”
When participants were asked to indicate how important a wide range of activities
were for their quality of life, on average they rated calendar, social communication,
healthcare, and recreation and learning activities as important to very important. These
contrasting sets of data for the categories of social communication, games, calendar
healthcare, recreation and learning, and are presented in Table 1. In terms of the
usefulness of current computer systems to support these activities, only the mean for
social communication and recreation and learning approached a “useful” rating. We
conducted a paired-sample t-test for each category to determine if the importance and
usefulness responses were significantly different (see Table 1). The alpha level for
significant effects was set at .001 to control for multiple tests.
Table 1. Importance and usefulness ratings

Activity categories Importance Usefulness Df t p
mean (SD) mean (SD)
Social communication 4.03 (.61) 3.97 (.90) 245 1.17 .243
Games 3.21 (1.17) 2.95 (1.41) 208 2.81 .006
Calendar 4.14 (.78) 2.49 (1.31) 230 17.26 <.001 (significant at .001)
Healthcare 4.02 (.73) 3.05 (1.08) 240 15.58 <.001 (significant at .001)
Recreation and learning 3.99 (.64) 3.77 (.93) 244 3.89 <.001 (significant at .001)
Note. Ratings were provided in the context of quality of life for importance (1 = not at all
important to 5 = very important) and the usefulness of computers and the Internet for supporting
tasks and activities (1 = not at all useful to 5 = very useful).
For social communication and games the ratings were not significantly different
suggesting that computers were perceived to be successful in meeting older adults’
needs for these categories. Yet, for recreation and learning, health, and calendar
activities the ratings of computer usefulness were significantly lower than the
importance ratings. To understand these patterns, we explored the data on an item level
to gain insights about perceptions of usefulness for different tasks in the same
categories.
Social Communication. We queried participants about six different social communi-
cation tasks; they were all deemed important to the older adults’ quality of life (mean
ratings > 3). Overall, the usefulness ratings were high with 3 of the tasks having a mean
rating above a 4. The older adults were especially likely to perceive the usefulness of
computers for communicating with family and friends and for staying in touch with
people over long distance.
Games. We asked participants about both individual games (e.g., Solitaire, Dominos,
Sudoku, puzzles) and group games (e.g., Bridge, Bingo, board games). Participants
rated both types as important (mean ratings > 3), however the computer was only rated
as useful for individual games, not group games (M = 3.37 and M = 2.33, respectively).
Considering both individual and group games and with an alpha set at .001, perceptions
of usefulness were not significantly different than those of importance for games.
Calendar. We queried about four different calendaring activities, including scheduling
events and setting reminders. Although calendaring activities were rated as important to
participants’ quality of life (mean rating > 4), computers were rated as not useful for
putting reminders on a calendar, creating appointment reminders, and tracking events
with a calendar. The only calendaring activity for which computers were perceived as
being useful was creating medication reminders. These findings indicate a mismatch
(and thus a potential opportunity) between activities older adults consider important for
their quality of live and the ability of computers to support them.
Healthcare. We queried participants about six different healthcare activities, all of
which were rated as important to the quality of life of the older adults (mean rating > 3).
Overall, the participants did not find the computer to be very useful for supporting the
health-related tasks, with the exception of most research tasks. Researching general
health issues, symptoms/illnesses, and medications were all above 3.0, suggesting that
the older adults perceived the usefulness of computers for research tasks.
There were three health tasks that were rated quite low in usefulness (i.e., com-
municating with doctors or other healthcare professionals, researching health insurance,
managing illnesses) but quite high in importance. These represent another mismatch
between the older adults’ needs and their perceptions of usefulness. Certainly com-
puting technology has the potential to assist with these tasks but the older adult
computer users in our sample did not perceive that usefulness.
In sum, clearly the older adults perceived healthcare activities as important to their
quality of life, most notably communicating with doctors or other healthcare profes-
sionals, managing illness and researching general illness, medications, and symptoms.
But there was a disconnect between the activities important to the respondents and their
perceptions that computers and the Internet can be useful for these tasks. The notable
exception to this pattern was for research.
Recreation and Learning. We asked participants about seven learning and recreation
activities, all of which were rated as important to their quality of life (mean ratings > 3).
Nevertheless, ratings of computer usefulness to support these activities were signifi-

cantly lower. The largest disconnect between importance and usefulness ratings were
for following the news, acquiring new skills, learning new information, and accessing
community resources. Although computers have the potential to be quite useful for
these types of learning and recreation activities, these older adults did not perceive
current computers as useful for such activities.
5 Discussion
The purpose of this study was to understand what types of activities are important to
older adults and whether computers are perceived as useful for providing support for
those activities. We explored the attitudes of experienced older adult computer users
about current computer usefulness for different activities because we wanted to
understand perceptions that were based at least partly on usage rather than primarily on
expectations and assumptions. We sampled an older adult population who became
users at a time when they were a minority user group in the older population (i.e., early
adopters [17]). Although these participants are not representative of the total population
of older adults, they are representative of older adult computer users, as reflected by
large-scale survey data (e.g., mostly white/Caucasian, highly educated, and in good
health) [18–20]. These experienced computer users showed a disconnect between what
activities were important to them and how useful they found computers for supporting
those activities, a finding contrary to what might be expected from technology-savvy
people. That is, even having considerable computer experience may not prevent an
individual from encountering barriers when trying to use computers for certain
activities.
Previous research has provided insight into the types of computer and Internet
activities older adults are engaged in. The Pew Research Center, in particular, has
provided much data about what activities older adults engage in using the Internet, such
as using email, search engines, hobby or interest, maps or directions [21]. Another
large-scale study also collected data on activity engagement and found almost 86 % of
Internet users 65 and older sent emails/text messages, 51 % shopped, paid bills, and/or
did banking, and 45 % conducted health-related tasks on the Internet. However, 9 % of
the users used the Internet only for sending emails/text messages and these users were
more likely to be socially and economically disadvantaged [22]. These findings provide
insights into Internet usage patterns of seniors and the findings presented here com-
plement those data showing also how important different activities are to older adults’
quality of life and how useful they perceive computers to be for providing support.
Our findings indicate that computers are meeting older adults’ needs for some
activities (e.g., social communication, games) more so than others (e.g., calendaring,
healthcare, recreation and learning), an insight that has significant implications for
training and design. For example, the finding that computers are meeting older adults’
needs for social communication and games is a point that should be highlighted for
their non-user peers during technology introduction and training. That is, if non-users
can see how their peers benefit from using computers, they may be more likely to see
those potential benefits for themselves.
Social communication was an activity our participants rated as important and that
the computer was useful for providing support. Indeed, the Pew Research Center
showed that email is a common computer activity of older adults [6]; 86 % of internet
users ages 65 and older use email and 48 % do so on a typical day [23]. Nevertheless,
there may be design opportunities for chat and social networking software. People are
living longer and therefore more likely to have mobility losses. The majority of older
adults are also choosing to stay in their homes. These factors may contribute to
increased social isolation for older adults, which may be particularly severe for their
age group [24, 25]. Consequently, there may be more of a need for social communi-
cation technologies in the future and the needs of older adults should be specifically
considered.
Playing games was another activity for which participants seemed to feel the
computer was meeting their needs. This finding suggests that computer games may be a
ripe entry activity to show non-computer users potential benefits of using computers.
Furthermore, games to support cognitive health by providing cognitive exercise are
becoming popular and are being marketed toward older adults. Although challenges
have been documented regarding the benefits of games for cognitive exercise [26],
there is promising evidence and increasing interest in computer games designed to
provide cognitive exercise [27]. However, the participants did not find the computer
useful for group games and this represents a missed opportunity for increasing social
interaction.
The older adults we surveyed did not view the computer as meeting their needs for
calendaring, healthcare, and recreation and learning activities. Calendaring activities
had the highest mean ratings for importance to quality of life and the largest mean
difference between importance to quality of life and usefulness of computers for pro-
viding support. The high value placed on the importance of calendaring is consistent
with the widely accepted finding that aspects of prospective memory declines with age
[28] and that older adults are aware of this decrement [29, 30]. Nevertheless, these
experienced computer users did not rate current computers as useful for supporting
calendaring activities. This is a prime domain for which computer software has the
potential to make a significant impact on the lives of older adults, yet our findings show
that more work is needed to develop systems that are useable and useful to older adults.
Healthcare is another domain for which computer systems may be particularly
useful for older adults [31], especially given that the percentage of adults with multiple
chronic conditions increases with age [32]. Nearly 90 % of older adults have at least
one chronic disorder [33]. In fact, in another large-scale survey, 53 % of adults who
were Internet users and had chronic conditions reported using information found on the
Internet in their decision-making about their own health or someone they care for [34].
However, with respect to design, the healthcare results presented here provided evi-
dence that current computer options are not meeting the needs of older adults. Even
experienced computer users did not perceive the usefulness of computers for a range of
important healthcare tasks such as managing illness, scheduling appointments, and
creating reminders for appointments or medications. These activities influence quality
of life and potentially health care costs and safety as well. This finding suggests an
opportunity for designers to capitalize on computing power to support these activities
of older adults.
Computers were also not seen as meeting participants’ needs for supporting rec-
reation and learning activities. These types of activities can be thought of as enhanced
activities of daily living [35] and are important for providing social opportunities and
cognitive exercise [36]. Future computer systems and software should be designed to
better support these activities, particularly in light of the relationship between social
isolation and mortality [37] and cognitive exercise and cognitive functioning [38].
Our findings provide guidance for (a) introducing the potential of computers to
current non-users and (b) design targeted to meet the needs of older adults and enhance
computing functionality for them. First, consider older adults who are currently
non-users. There are of course many reasons why people choose not to use computers,
some of which may relate to financial cost or lack of training opportunity. However,
perceived usefulness, attitudes, and anxiety are also predictive of computer and tech-
nology use [8, 9]. In fact, the most frequently stated reason for not using the Internet
was ‘not interested’ (31 %) [21]. It is likely that many of the respondents who indicated
they were not interested do not perceive the Internet as being useful. The present
findings illustrate the value of computers for older adults performing activities that are
important to their quality of life. Communication with family and friends in particular
was important to life quality and computers were perceived as useful for these activ-
ities. Therefore, these activities are likely to be a good point of introduction for
motivating and engaging older adults to use computers.
Acknowledgements. This research was supported in part by a grant from the National Institutes
of Health (National Institute on Aging) Grant P01 AG17211 under the auspices of the Center for
Research and Education on Aging and Technology Enhancement (CREATE; www.create-center.
org). Data from this general questionnaire were presented at Human Factors & Ergonomics
Society (Burnett et al., 2011), FICCDAT (Mitzner et al., 2011), GSA (Mitzner et al., 2011), and
at the Cognitive Aging Conference (Burnett et al., 2012).
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Useful or Easy-to-Use? Knowing What Older
People Like about Near Field Communication
Technology
Pei-Lee Teh1(&), Pervaiz K. Ahmed1, Alan H.S. Chan2,

Soon-Nyean Cheong3, and Wen-Jiun Yap3
1
School of Business, Monash University, Bandar Sunway,
Selangor Darul Ehsan, Malaysia
{teh.pei.lee,pervaiz.ahmed}@monash.edu
2
Department of Systems Engineering and Engineering Management,
City University of Hong Kong, Kowloon, Hong Kong
[email protected]
3
Faculty of Engineering, Multimedia University, Cyberjaya, Malaysia
{sncheong,wjyap}@mmu.edu.my
Abstract. The goals of this study are two-fold: (1) To develop a novel concept
of a light system with the use of Near Field Communication (NFC)-enabled
technology, Bluetooth and Raspberry-PI. This new system is known as NFC
Light System (NLS). (2) To set up an experimental design to examine the
influence of perceived usefulness and perceived ease of use on older adults’
behavioral intention to use the NLS. Our proposed system was empirically
tested with 33 older adults in Malaysia. Our findings show that perceived ease of
use appears to be the primary factor for the older adults to use the NLS.
Interestingly, perceived usefulness was not a significant predictor of older
adults’ behavioral intention to use the NLS. From the practical viewpoint, this
study offers a new insight for gerontechnology manufacturer and developers to
focus their design efforts on easy-to-use attribute that are desired by older adults.
Keywords: Technology acceptance model Experimental design Geron-

technology Near field communication Malaysia
1 Introduction
The demographic profile of the world population has undergone significant transfor-
mation over the recent years, with one of the main demographic shifts is population
ageing. The proportion of older adults (aged 65 year-old and above) has been
increasing and the number is projected to raise from 841 million in 2013 to more than
2 billion in 2050 [24]. It was also reported that 40 percent of the older adults aged
60 years or above live independently [24], and projections indicate that the number of
older adults living alone will rise considerably into the future. Given that older adults
spend more time in and around their house, duty for care of this older population
involves providing them with a safe and healthy home environment, in which they are

DOI: 10.1007/978-3-319-20892-3_27
274 P.-L. Teh et al.
able to function independently. In this vein, gerontechnology is becoming an

increasingly important means to support the older adults’ vitality and independence.
According to Fozard et al. [10], gerontechnology is a word bearing gerontology
(scientific study of aging) and technology (the development and implementation of
technological products, services and physical environments). Gerontechnology relates
to the use of technology for the benefit of both aging and aged people [5, 9, 25]. Within
the scope of gerontechnology, technology is not an end in itself but a means to support
the aging people for a better life [2]. Hence, both gerontological and technological
studies are closely connected.
The core of gerontechnology focuses on the impact of different technologies within
five domains of human activity [9, 25]. The five domains of human activity include:
(1) Health and self-esteem (technology supporting physical, cognitive and emotional
functioning of older people); (2) Housing and daily living (technology supporting
independence, convenience and safety of daily activities among the older people);
(3) Mobility and transport (technology supporting personal mobility of older people);
(4) Communication and governance (technology supporting societal cohesion, the use
of TV, Internet, mobile phone, etc., and remote monitoring of functional status of older
people); and (5) Work and leisure (technology supporting older people to continue their
work and perform educational and recreational activities). An example of housing and
daily living domain includes developing smart technology for controlling lighting and
heating that can help to address the limitations in physical function of older adults [10].
The 21st century has witnessed an unprecedented change in the way how tech-
nology affects people’s daily lives. Today, numerous products and services are avail-
able, particularly with the proliferation of near-field communication (NFC)-enabled
technology. This study focuses on NFC-enabled assistive technology in the home
environment. As light/lamp is an everyday product that older adults use it in their daily
lives, interest in NFC-enabled light system is timely and relevant.
In most instances, new technologies have great potential usage in ageing popula-
tion, but successful implementation of the technology is highly dependent on the user’s
technology acceptance. Regardless of the extant gerontechnology studies published on
electronic government services [19], health-related technology [11], smartphones [28],
telecare services [21], there is still room for research that furthers the understanding of
factors affecting technology adoption among the older adults. In this study, we draw on
Technology Acceptance Model (TAM) to examine the older adults’ technology
decision.
Taken together, the goals of this study are two-fold: (1) To design an assistive
technology for the home environment, we develop a light system with the use of
NFC-enabled technology, Bluetooth and Raspberry-PI. This new system is known as
NFC Light System (NLS). (2) Building from the lens of TAM, we examine the
influence of perceived usefulness and perceived ease of use on older adults’ behavioral
intention to use the NLS.
In the following sections, we first discuss the design and development of NLS.
Thereafter, we draw from TAM to develop our research hypotheses. This is followed
by a description of the research method and results. We finally conclude this paper by
discussing the findings, research implications, limitations and directions for future
research.
Useful or Easy-to-Use? Knowing What Older People Like 275
2 Literature Review and Research Hypotheses

2.1 NFC Light System (NLS)
In technical research, NFC is known as a wireless technology for data transfer within
short-range distance [27]. NFC technology supports two-way data exchange in digital
devices [18]. For example, an NFC device can act as a smart key to interact with other
NFC-enabled tag/device [18]. Technically, NFC-enabled devices can manage three
operation modes, viz., read/write, peer-to-peer and card emulation mode [14].
In this study, we applied the NFC read operation to design and develop the NLS.
The design of the NLS uses a set-top-box as a convergence platform, enabling the users
to interact with the lamp using a NFC card. In other words, NLS uses the concept of
tap-to-connect mechanism where operations are triggered by touching NFC card with a
set-top-box. Furthermore, NLS does not require Internet connection for operations.
With the use of Bluetooth Low Energy-enabled Raspberry-PI, users are only required
to connect NLS with power source to activate the operation. Given that NLS is an
assistive technology where users do not need to reach the light switch/lamp to switch
on/off the light, our proposed NLS provides a fast and convenient home experience for
older adults. The features of NLS include portable, easy-to-use and very low power
consumption, thereby augmenting an independence experience for older adults.
2.2 Tam
The theoretical framework for this paper is drawn from TAM, a revised version of
Theory of Reasoned Action (TRA) [7]. TAM was introduced in 1986 and has been the
robust model to study users’ technology acceptance [13, 22]. In the gerontechnology
literature, several studies (e.g., [1, 3, 6, 17, 19, 20]) have applied TAM in under-
standing older adults’ technology adoption decision. Within the TAM framework,
Davis [7] posits that technology usage is predicted by behavioral intention that is
affected by two key variables, namely, perceived ease of use and perceived usefulness.
According to Karahanna et al. [12:788], perceived usefulness is defined as the
“instrumental value derived from use of a technology.” For example, users are not keen
to use the service application if it is not beneficial [15]. Past gerontechnology research
has reported that perceived usefulness had a positive effect on older people’s Internet
use intention [17], intention to use social networking websites [3], and intention to use
the electronic governance services [19]. In the context of NLS, we expect a positive
usefulness-intention relationship among the older adults. Therefore, we propose:
H1: Perceived usefulness will have a significant positive influence on older adults’
behavioral intention to use the NLS.
Davis [7:320] defines perceived ease of use as “the degree to which a person
believes that using a particular system would be free of effort.” Davis [7] postulates that
a user will accept a system that is regarded to be easy-to-use. There have been strong
empirical results that support that perceived ease of use has a positive relationship with
behavioral intention (see: [17, 19]). In application to our study, perceived ease of use
will have a positive impact on older people’s behavioral intention to use the NLS.
Therefore, we propose:
H2: Perceived ease of use will have a significant positive influence on older people’s
behavioral intention to use the NLS.
3 Research Methodology
3.1 Measures
In this study, the survey instrument used to operationalize the three variables were
adapted from well-established literature and modified for use in the NLS context.
Survey questions of perceived ease of use were adapted from [4, 7, 26]. Three new
survey items were developed to measure perceived usefulness. Behavior intention to
use the NLS was measured using items adapted from [4, 7, 23, 26]. Respondents were
asked to indicate the degree to which they agreed or disagreed with each survey item,
on a seven-point Likert scale from 1 (strongly disagree) to 7 (strongly agree).
3.2 Sample
The target sample was older adults in Malaysia. The current sample consists of 33
participants, who are part of a larger on-going study. Voluntary consent was sought and
obtained from each participant. All research procedures were performed with the
Table 1. Profile of participants

Variable Classification Frequency Percent
(n = 33) (%)
Gender Male 12 36.4
Female 21 63.6
Age 55–64 10 30.3
65–74 12 36.4
75–84 8 24.2
Above 85 3 9.1
Highest Education Informal (no schooling or 8 24.2
Completed self-learning)
Primary School (completed 4 12.1
primary 1 to 6 education)
High school (completed form 10 30.3
1 to form 5 education)
Diploma 4 12.1
Bachelor degree/ 4 12.1
professional qualification
Master degree 1 3.0
PhD degree 2 6.1
approval of university’s human ethics review board, and informed consent of all
participants.
Our participants included 12 males and 21 females. Table 1 shows our sample
demographic profile including gender, age, and the education level.
4 Data Collection
Our experiential product was an in-house developed NLS. There were three compo-
nents in this system, namely the NFC-enabled card, set-top-box and the lamp. Each
participant was requested to switch on/off the lamp by tapping the NFC card on the
set-top-box. After the practice session, participants were asked to complete a survey
questionnaire about the experiment.
5 Results
5.1 Reliability, Validity and Factor Analyses

IBM SPSS software was used to check the psychometric properties of the survey
instrument, and to test our hypothesized model. Reliability of the scales was tested
using Cronbach Alpha. As shown in Table 2, all scales were reliable as the values of
Cronbach Alpha were greater than 0.70, and met the desirable values suggested by
[16]. Both convergent and discriminant validity were assessed using Average Variance
Extracted (AVE). As presented in Table 2, convergent validity was confirmed as AVE
of all constructs were at least 0.50, meeting the cutoff value suggested by Fornell and
Larcker [8]. Discriminant validity was tested through the comparison of square roots of
the AVE of construct pairs to the correlation between construct pairs. As shown in
Table 2, all the square roots of AVE values were greater than the off-diagonal coef-
ficients of construct pairs, providing an evidence of discriminant validity.
Principal component factor analysis was conducted to check the construct validity.
The factor loadings, Kaiser-Meyer-Olkin (KMO), Bartlett test of sphericity, and
eigenvalues of our model are shown in Table 3. All variables exhibited good construct
validity.
Multiple regression analysis was performed to test the model. Table 4 and Fig. 1
show the results of multiple regression analysis. The predictors explained 52.1 percent
of behavioral intention’s variance in hypothesized model. Perceived ease of use
(β = 0.646; p-value < 0.001) was the dominant factor predicting older people’s
behavioral intention. Our results showed non-significant perceived usefulness-intention
relationships (β = 0.131; p-value > 0.05). These results lend support to hypothesis H2
but not H1.
Table 2. Results of reliability and validity

Perceived Perceived ease Behavior
usefulness of use intention
Perceived usefulness 0.893
Perceived ease of 0.512** 0.829
use
Behavior intention 0.462** 0.713** 0.943
Average variance 0.797 0.688 0.889
extracted
Cronbach’s alpha 0.848 0.844 0.930
Standard deviation 1.275 0.596 1.378
Mean 5.647 6.152 5.434
Note: ** All correlations are significant at the 0.01 level (2-tailed); Italicized
values in the diagonal row are square roots of the AVE.
Table 3. Results of factor analysis

Variable No. KMO BTS EV Factor Loadings
of Item Item 1 Item 2 Item 3 Item 4
PU 3 0.728 46.843*** 2.390 0.863 0.907 0.907 Nil
PE 4 0.658 62.472*** 2.751 0.872 0.852 0.695 0.885
BI 3 0.758 81.191*** 2.669 0.926 0.949 0.954 Nil
Note: *** p < 0.001; KMO = Kaiser-Meyer-Olkin; BTS = Barlett’s Test of Sphericity;
EV = Eigen-values; PU = Perceived usefulness; PE = Perceived ease of use; BI = Behavioral
intention
Table 4. Results of Regression Analysis

Βeta Coefficient Standard Error
(Constant)
Perceived Usefulness 0.131 0.159
Perceived Ease of Use 0.646*** 0.340
R2 0.722
Adj. R2 0.521
F 16.338
Sig. 0.000***
Note: Dependent Variable = Behavioral Intention; *** p < 0.001
H1: β =0.131, p=0.379

Perceived
Usefulness
Behavioral Intention
Perceived
Ease of Use H2: β =-0.646, p=0.000***
Fig. 1. Results of regression analysis
Our findings show that perceived ease of use appears to be the primary factor for the
older people to use the NLS. This finding is consistent with Pan and Jordan-Marsh
[17], where they found a strong effect of perceived ease of use on Internet use intention
for older adults. Our result indicates the importance of an easy-to-use technology
design in encouraging technology adoption among the older adults. Interestingly,
perceived usefulness was not a significant predictor of older people’s behavioral
intention to use the NLS. One possible explanation for this finding is that older adults
do not necessarily adopt new technology even though the technology is a useful
practical tool for them. Perception of usefulness/benefits was not the motivational
factor for using a new assistive technology for older adults.
From the practical viewpoint, this study offers a new insight for gerontechnology
manufacturer and developers to focus their design efforts on easy-to-use attribute that
are desired by the older people. In addition, the NLS contributes in itself as a novel
gerontechnology design. The proposed NLS is an effective assistive technology for
older adults in maintaining their vitality and independence.
This study has two research limitations that should be acknowledged. First, data
was collected from Malaysia and future research should be conducted in other countries
to improve the generalizability of our findings. Second, we applied TAM as the the-
oretical basis in this study. Future studies should examine others variables and their
relationships by drawing from different theoretical frameworks such as Innovation
Diffusion Theory and Unified Theory of Acceptance and Use of Technology
(UTAUT).
Acknowledgements. The authors thank the Ministry of Science, Technology and Innovation
(MOSTI), Government of Malaysia, and Monash University Malaysia campus for financially
supporting this research under contract ES-1-14/06-02-10-SF0211 and B-5-14. The authors
would also like to thank all the research assistants (Cherish Voo Wen Yee, Natalie Ong Xi Men,
Jayden Liew Yee Jin, Wong Poh Teng and Esther Tan En Yi) in the data collection. Most of all,
heartfelt gratitude goes to the respondents of the study.
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Pitfalls when Placing Electricity Pylons - The
Influence of Age on Acceptance
Barbara S. Zaunbrecher1(&), Katrin Arning1, Baris Özalay2,

Hendrik Natemeyer2, and Martina Ziefle1
1
Human-Computer Interaction Center, RWTH Aachen University,
Aachen, Germany
{Zaunbrecher,Arning,Ziefle}@comm.rwth-aachen.de
2
Institute for High Voltage Technology (IFHT), RWTH Aachen University,
Aachen, Germany
{Oezalay,Natemeyer}@ifht.rwth-aachen.de
Abstract. The increasing penetration of renewable energies influences and

changes the transmission task of electricity in Germany. However, the planning
and construction of new lines is met with resistance from the public. To address
public concerns adequately, a tailored information and communication concept
is needed, for which knowledge about acceptance-relevant factors for different
user groups is indispensable. In this paper we explore acceptance-relevant
attributes in the context of electricity pylons contrasting attitudes of older and
younger persons. Results of a conjoint study indicate that both age groups
basically have comparable acceptance levels, but younger persons were found to
be more sensitive with regard to distance of the pylon and possible health
effects. Additionally, acceptance patterns similar to those for cell tower location
were found, which implies that the analyzed attributes are not only stable across
demographic groups but also across technologies.
Keywords: Energy infrastructure Technology acceptance Electricity

pylons User diversity Renewable energies Conjoint analysis
1 Introduction
The future high proportion of feature-dependent power generation as a consequence of

the increasing penetration of renewable energies influences and changes the trans-
mission task of electricity. Especially the high wind power capacity in the north of
Germany requires an electricity transport from the north to the south of Germany. This
is why the need for new transmission lines is a vital topic for the achievement of the
ambitious aims of the energy transition.
But, the planning and construction of new lines is often met with resistance from
the public, as they fear e.g. health problems due to radiation [1, 2] or criticize the visual
impact on the landscape [3, 4]. Ignoring this criticism may lead to citizens’ protests,
which can cause delays and even cancelling of entire projects [5, 6]. Thus, public
acceptance is a critical factor not only for the successful but also for the sustainable

DOI: 10.1007/978-3-319-20892-3_28
Pitfalls When Placing Electricity Pylons - The Influence of Age 283
implementation of novel technologies. Often it is assumed that any novel technology

naturally evokes concerns and criticism in the very beginning and that those concerns
fade as the public gets attuned to it over time [7]. Nonetheless, there are some major
arguments to actively address the concerns, for two reasons: First, technology accep-
tance is a complex phenomenon [8, 9] which needs a specific evaluation methodology
[10]. Different from former studies on acceptance, in which a more or less static single
factor evaluation was done, it is increasingly understood that reliable acceptance
decisions include several factors at a time. Characteristically, negative factors and
positive factors are weighed, related to each other and then built to a final decision.
This is especially the case in large-scale technologies, in which many, some times
contradictory motives on different (time)scales have to be considered. Thus, contem-
porary acceptance research must be directed to identifying the relevant factors,
understand the nature of the weighing and factors compensating each other and learn
which of the factors might be scalable. Second, public acceptance should be imple-
mented as early as possible within the technology development in order to adapt
technology decisions in line with public opinions. Understanding the fears and wishes
of the citizens is the grounding to react adequately and to specifically tailor commu-
nication and information policies. A prerequisite for such a concept to be successful is
the knowledge about which acceptance-relevant factors are important to which user
groups [7]. Understanding aged persons seems to be an especially crucial cornerstone
in the context of technology acceptance, as many European countries face a demo-
graphic change with an increasing penetration of life with technology. Multiple studies
have therefore addressed the attitude towards technology of older adults [8, 11–13]. For
renewable energies, age was found to also influence attitudes towards green energy,
nuclear energy and micro-scale technologies [14]. In particular, it was for example
found that older persons were less positive towards wind power [15] and were less
willing to pay for renewable energy and energy efficiency [16].
As the grid expansion is a topic closely related to the turn towards more renewable
energy sources, it is reasonable to assume that age also plays a role for the acceptance
and preferences concerning pylon placement. Therefore, we focused on an age contrast
with regard to acceptance-relevant factors of electricity pylon siting. Two research
questions on this topic will be addressed in this study:
1. How do different acceptance-relevant attributes in the context of electricity pylons
siting (health concerns, compensation payment, distance to housing, location of
installment) relate to each other?
2. Can age-effects be found for the weighing of these factors?
To answer the research questions, we conducted an empirical study (conjoint analysis)
which was designed as an online study. Our research contributes to the existing lit-
erature on acceptance of energy infrastructure, as well as the influence of user factors
on acceptance patterns. It provides useful insights for energy providers, urban planners
and energy policy makers into social acceptance patterns and possible pitfalls for the
siting of power lines.
284 B.S. Zaunbrecher et al.
2 Grid Expansion in Germany and Specifications

for Placements of Electricity Pylons
The transformation to a sustainable energy supply without the use of nuclear power and
with low carbon emission in Germany leads to changing geographical electricity
generation patterns and thus to changing electricity transmission needs. The transport
of electrical energy over long distances is usually performed by voltage levels of
220 kV and especially 400 kV. Most lines at those voltages are built as overhead line as
underground cabling as option is still lacking technical long-term experience at those
voltage levels and is much more expensive.
To avoid unnecessary extension, the NOVA-principle1 is applied in Germany. It
implies that prior to the construction of new lines, the optimization as well as the
reinforcement of the existing infrastructure (i.e. by mounting additional circuits on
exiting poles) has to be carefully analyzed.
The need for reinforcement is usually identified on a point-to-point basis, which
means that the concrete routing of the lines is not or only to a limited extent con-
sidered. Once the need for the new connection is determined by the system operator
and confirmed by the national authority2, it finds its way into the Federal Requirement
Plan – still on a point-to-point basis. In the next steps the transmission system
operator elaborates a first suggestion and possible alternatives for the routing of the
line, initially in terms of an up to 1000 m wide corridor and later with precise
positions for the pylons. In each case, the following process is led by the federal state
authority or by the national authority, in case more than one federal state is con-
cerned. Every citizen or organization is invited to get involved in the process which
targets to identify a routing that considers technical, economic, environmental and
social aspects. As a result, the system operator can be committed to analyze additional
alternatives and obtain expert advice. The responsible authority eventually decides on
the final routing.
With regard to technical aspects, it has to be considered that the length of a line
determines its technical parameters. The isolation distance needs to be kept, so that
vegetation in the closer surrounding of the line is only possible to a limited extent and
the underground has to be suitable for the foundation of the pylons. The complexity of
the construction of a line is also higher, if the route is twisty as the direction of the line
has to chance often and more or different pylons have to be built. On the voltage level
of 220 kV and above, no special need for closeness to residential areas exists as the
supply of the consumers is performed with lower voltages. Nevertheless, at some points
the closeness to residential areas cannot be avoided. In these cases, the knowledge
1
NOVA means “Netzoptimierung vor Verstärkung vor Ausbau,” in English: “network optimization
before reinforcement before extension”.
2
Bundesnetzagentur.
about public preferences for siting scenarios is crucial at this point in order to timely
react on possible concerns and to develop a solution that suits both, developers and
citizens.
3 Methodology
A Choice-Based Conjoint (CBC) study was designed with Sawtooth Software as an

online survey. Originating in market research, conjoint analysis is a measurement
approach that allows for the determination of relative preferences and closely mimics
decision processes of respondents. In conjoint analyses, participants are presented with
a set of attributes that make up a product, or, in this case, a scenario. Participants
compare different scenarios against each other, which are defined by the same attri-
butes, but by different manifestations (or levels) of the attributes. This way, participants
are forced to take into account bundles of characteristics for their choice rather than
comparing isolated characteristics of scenarios. Because of this, the choice task models
real-life decisions in a more realistic way than other types of questionnaire techniques.
By analyzing the choice behavior of the participants, it is possible to calculate the
importance of one attribute for the decision relative to the other attributes (relative
importance), and furthermore, to calculate the value of a level of an attribute for the
choice of a scenario relative to the others levels of an attribute (part-worth utility).
Questionnaire Design. The questionnaire included items on demographic information,

living area, proximity to electricity pylons and the use of “green electricity”. Because
earlier studies have shown that technical self-efficacy (TSE) [17] has an effect on
technology acceptance and attitude towards energy related infrastructures, TSE was
measured using eight selected items from Beier’s TSE-questionnaire [17] for which
reliability had been previously tested [9]. All questions, with the exception of the
demographic information, were answered on a six-point-Likert scale (“1 = do not agree
at all” to “6 = fully agree”). Finally, participants were invited to leave comments on the
topic.
Experimental Design/Selection of Attributes. For the conjoint task, the four attributes
“location”, “distance to home”, “health effects” and “compensation payment” were
chosen and were assigned appropriate levels (Table 1). Participants were presented
with different infrastructure scenarios that differed concerning the frequency of health
concerns, distance of the pylon to housing, location of pylon and amount of com-
pensation payment. The attributes were chosen based on prior research on acceptance
of technology infrastructure (mobile phone masts [10]) and the consultations of experts.
They were adapted to the context of electricity pylons when necessary. This meth-
odology additionally provides the opportunity to compare the same acceptance-relevant
attribute across different technologies (mobile phone masts and electricity pylons) and
identify possible generic fears and perceived threats that are stable across technologies.
Levels were illustrated by pictures to enhance understanding (Table 1).
Table 1. Attributes and levels used in the conjoint study
Location Distance to home Frequency of health Compensation

effects payment
never 0
near existing
infrastructure 400m
on an open field rarely 250

800m
in a forest sometimes 500

1200m
often 1000
In an introduction before the conjoint tasks, the attributes, levels and mode of the
survey were explained to the participants. For location, the levels “near existing
infrastructure”, “on an open field” and “in a forest” were chosen. These locations
represent possible locations according to current policies for pylon siting in Germany.
It is assumed that they are accepted differently, as they present a different degree of fit
in a landscape: while the pylon on an open field is highly visible, a location in a forest
disguises the lines, however, it comes at the cost of cutting down trees. Placing pylons
near existing infrastructure has been favored in other studies on the subject, as it
minimizes additional interferences with the environment. The “distance from home” is
set at 400 m, 800 m and 1200 m. It was communicated to the participants in the
introductory part of the study that even the nearest location (400 m) was in line with
current regulations and fulfilled the security standard. Finally, possible subjective
health risks such as dizziness, headaches etc. which are associated with EMF emitted
from transmission lines were introduced at frequency levels (“never”, “rarely”,
“sometimes” “often”) [10]. The levels of the different attributes were combined into
scenarios from which the participants had to chose the one they preferred most. For
each choice task, the respondent was presented with three scenarios (Fig. 1). Because a
full-factorial design would have yielded 144 (3 × 3 × 4 × 4) possible scenarios to judge,
the amount of stimuli was reduced, so each participant only answered nine choice tasks,
which were randomized across participants. To ensure design efficiency, a test for
efficiency was applied (provided by Sawtooth Software). Taking into account 184
participants, the design was reported to have an efficiency of 100 % compared to the
fully orthogonal design.
Data Collection. Data were collected in an online survey in Germany by distributing
Fig. 1. Example of an original choice task from the conjoint study
the survey in social networks and online discussion forums. Citizen groups affected by
the building of new power lines were especially invited to take part in the survey. The
survey took approximately 15 min to complete.
3.1 Sample
231 participants took part in the survey. Because Sawtooth Software requires complete
datasets for the conjoint analysis, all datasets with missing answers were excluded, so
that 184 datasets remained for analysis. 44 % of the sample was female, 56 % male and
the average age was 36.2 years (SD = 14.3). More than half of the participants (56.5 %)
reported to hold a university degree, which shows that the sample was highly educated.
The majority of the sample lived in the city center (41.3 %), followed by people living
in the outskirts of a city (34.8 %), and the smallest group lived on the countryside
(23.9 %). Most participants lived in an apartment house (60.9 %), further 26.1 % lived
in a detached house.
On a scale of 1 (lowest) to 6 (highest), the average score for TSE was M = 4.6
(SD = 0.9). The self-reported knowledge about the grid expansion was low (M = 2.8,
SD = 1.2). To control for effects of familiarity, participants were asked whether they
lived within view of an electricity pylon (yes: 27.2 %, no: 72.8 %).
4 Results
The results of the conjoint analysis, average importances and part-worth utilities will be
presented first for the whole sample and then contrasted for the two age groups.
Looking at the sample as a whole, an analysis of the average importances showed
that health effects were by far the most important attribute for the choice of a scenario
(Fig. 2) (54.8 %). It was followed by “location” (28.3 %), then by “distance” (11.0 %).
A one-time compensation payment was the least important attribute (5.9 %).
Fig. 2. Mean importances for attributes of pylon location scenarios (n = 184)
Next, the part-worth utilities for the different levels of the attributes are described
(Fig. 3).
Fig. 3. Part-worth utilities for attributes location, distance to home, frequency of health effects,
compensation payment (n = 184)
It was found that a pylon location near existing infrastructure was most accepted
(53.5), while the location in a forest was the least accepted (–45.2). The location on an
open field was less accepted than the placement near existing infrastructure, but more
than the location “forest” (–8.2). Concerning the distance to home, the distances were
accepted in descending order: the furthest away the pylon (1200 m), the more accepted
the distance was (16.8). Next, the most important attribute “health effects” is examined.
Participants accepted the most frequent health effects the least (“often”: –124.1), and
the least frequent health effects (“never”: 87.6) the most. The opposition and accep-
tance were particularly strong for this attribute, as the large difference in utility values
for the most and least accepted level showed (211.7), which is also reflected in the
overall high average importance of this attribute. The compensation payment had
almost no effect on the choice of the pylon placement scenario, which is illustrated by
the very small differences in the part-worth utility values (difference between most and
least accepted level: 7.0). Interestingly, the highest compensation payment of 1000€
was strongly rejected (–4.4), whereas 0€ and 500€ received the same, slightly positive
rating (0.9). The most preferred compensation payment value was 250€ (2.6).
In the following, age effects were addressed. Participants were split into two age
groups (“younger” group (<50 years), “older” group (50+ years)). The groups did not
differ significantly in terms of gender distribution, however, the “older” group had a
lower overall educational level (p ≤ 0.01), lived on the countryside and in the outskirts
of a city rather than in the city center (p ≤ 0.01), and had a (slightly) lower TSE
(p ≤ 0.01). They did not differ in other possible influential factors on acceptance such
as familiarity (living within view of pylons) or knowledge about grid expansion.
In a first step, the average importances for the young and old were compared
(Fig. 4). It is evident that the groups did not differ greatly with regard to the most
important attributes for the choice of the pylon-placement scenario. For both groups,
possible health effects were the most important attribute when choosing a scenario,
however, this was slightly less so for the older group (46.5 compared to 55.8). In
contrast to this, the location was less important for the younger age group (26.6) than
for the older participants (31.4). The distance had equally low importance for both
groups (11.4 and 11.5). Compensation payment had an overall low importance, but its
effect on the choice of a scenario was stronger for the old (10.5) than for the young
group (6.2) (Fig. 4).
Fig. 4. Average importances for attributes of pylon location scenarios (younger: n = 141, older:
n = 43)
Analyzing the attribute “location” for the two groups revealed that younger and
older participants did not differ to a great extent in their preferences for the pylon
setting. Both groups preferred a siting scenario in which the pylon is placed next to
already existing infrastructure, followed by the placement on a field. The placement in
a forest is most strongly rejected by both groups (Fig. 5).
Fig. 5. Part-worth utilities for attribute “location” for age groups (young: n = 141, old: n = 43)
The preferences for the distance from the current place of living were more distinct
between the two groups than for the location. The older and younger participants
agreed in the fact that the closest location (400 m) was the least accepted. However, the
young group preferred 1200 m over 800 m, while it was the other way around for the
older participants. It is also noteworthy that the preference for 1200 m over 800 m by
the young group was clearer (difference between the two levels: 15.9) than the pref-
erence of 800 m over 1200 m by the old group (difference: 7.0), indicated by the greater
difference between the part-worth utility scores for the young group (Fig. 6).
Fig. 6. Part-worth utilities for attribute “distance” for age groups (younger: n = 141, older:
n = 43)
The preference patterns for the attribute “health effects” were the same for the two
age groups: in both groups, acceptance declined with an increasing frequency of health
effects. It is notable that health effects which occur “often” were much stronger rejected
in comparison to “sometimes” by the young (–128.6) than by the old group (–92.7)
(Fig. 7).
As already mentioned above, the compensation payment had only a very small
effect on the choice of the pylon placement scenario, which is illustrated by the very
small differences in the part-worth utility values. Differences between the groups exist,
but they should not be overestimated because of the overall low effect on the choice of
Fig. 7. Part-worth utilities for attribute “health effects” for age groups (younger: n = 141, older:
n = 43)
the scenario. It is remarkable, however, that the highest compensation payment is not
the best-accepted solution for either of the two groups (Fig. 8).
Fig. 8. Part-worth utilities for attribute “compensation payment” for age groups (younger:
n = 141, older: n = 43)
Concluding, the best accepted scenario for the young participants would be a pylon
placement near existing infrastructure, 1200 m away from their residential location,
causing no health issues, with 500€ compensation payment. The scenario for the old
participants looks similar: near existing infrastructure, with no health effects, but only
800 m away from their home with 250€ compensatory payment.
5 Discussion
Overall, the study was based on two different research questions. One was directed to
the question if age of persons has an influence on the preference for a pylon placement
scenario and the way the acceptance relevant criteria were evaluated. The results
indicate that this is only partly true. It was found that the overall importance of the
presented attributes was the same for young and old participants. The only noteworthy
difference was found for the preference of the distance to home and frequency of health
effects. Young participants presented themselves more sensitive than the older group:
They favored a pylon location that was further away and were also more critical about
possible health effects. A possible explanation could be that young people are generally
in a better state of health than elders, and are thus more critical towards any impairment
that could be caused. The overall more pronounced criticism of the young in combi-
nation with a higher technical self-efficacy compared to the older group could be an
effect of them being better informed and thus also more informed about possible
negative consequences.
Concerning the acceptance of compensation payments, it does not seem logical that
the highest amount of compensation payment should have a similar part-worth utility
value to “no compensation payment”, and that 250€ are more accepted than 500€.
Because of the minor differences in the part-worth utilities, the “preferences” for the
different amounts of payment will be treated as pure chance. Given the fact that this
attribute had hardly any significance at all and that the preferences were rather arbitrary,
it seems that compensation payment does not have an effect on the acceptance of a
siting scenario. Future studies will have to evaluate whether this is because the payment
offered is too low, or because health effects cannot be compensated with money or if a
compensation payment is rejected altogether in this context.
Another interesting finding is the striking parallel to the study with similar attri-
butes on cell tower placement by Arning et al. [10]. In both studies, health effects were
found to be the most important attribute for the choice of a scenario. Compensation
payments, in contrast, were among the least important attributes. This suggests that
these preference patterns are stable not only across different groups of people, but also
across different technology contexts. With regard to the planning of any infrastructure,
which could cause concerns related to health, this means that planners of such infra-
structures should be aware of the power of these concerns.
There are of course further factors influencing acceptance of transmission lines
which have not been treated in this study because of the special methodology chosen,
for example fairness of the decision process and the influence of the sources of
information, as mentioned by one participant in a comment:
“(Acceptance of the new transmission line) depends on the objective necessity for the local
electricity supply, which has not been proven by independent sources. (…) As long as we feel
cheated by the economy and politics, there will be no acceptance of the new transmission lines.”
(female, member of citizen protest group)
Regardless of the results found in this study, the possibility remains that differences
between groups based on user characteristics also exist in the case of pylon placement,
bearing in mind that the sample was very well educated. It would be insightful to
extend the research onto other target groups for communication and information
concepts, also taking into account the role opinion leaders play for citizen protest
against power line siting.
Acknowledgements. Thanks to Clara Erner, Lino Kolb and Chantal Lidynia for research
support. This work was funded by the Excellence Initiative of German federal and state gov-
ernment (Project “Urban Future Outline”).
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Aging, the Web and Social Media
Usability Evaluation of a Social Networking
Site Prototype for the Elderly
Jessica Arfaa(&) and Yuanqiong (Kathy) Wang
Department of Computer and Information Sciences,

Towson University, Towson, MD 21252, USA
{jessicaarfaa,ywangtu}@gmail.com
Abstract. Social networking sites offer a number of benefits; however a large

amount of elder adults still do not engage in these types of sites due to usability
issues and a lack of understanding of Web 2.0 concepts. To alleviate these
issues, a social networking site interface was redesigned to accommodate elders
so that they can reap the benefits of social media. Following a three phased
usability study, 22 elder adults utilized a redesigned website incorporating web
standards and additional usability and accessibility considerations. With the use
of the redesigned prototype, does it improve accessibility and usability for elder
adults? What tasks improved in terms of success rates and task performance?
How do the elders perceive the newly redesigned prototype? The preliminary
findings of this study show that usability and accessibility for elder adults
improved when utilizing the redesigned social networking site. In addition, elder
adults had a more positive perception of these types of sites after using the
redesigned prototype.
Keywords: Social media Social networking Elder adults Usability study
1 Introduction
Social networking sites such as Facebook [6], Google+ [7], and LinkedIn [9], offer a
number of benefits. They allow users to learn, share resources, collaborate, and build
relationships with friends, families, co-workers, and people with similar interests [11].
For example, users are able to read posts and obtain quick feedback from others by
communicating on related pages. Ideas, stories, and media can be easily shared in an
organized fashion through commenting, tagging, trending, etc. The nature of these sites
also allows for relationship building despite users’ physical location or time constraints.
As people age, there is an increased likelihood of health impairments and logistical
issues which may present barriers for the elderly connecting to the outside world. With
the capability of social media, there is potential to break such barriers and make it
possible for the elderly to live a more independent life. However, out of the 40 million
elder adults aged 65 years and older, a little more than half (53 %) engage in online
activities, such as checking email and searching the internet. Of these online elders,
only a small percentage (32 %) use social media (such as social networking sites) [4].
Therefore, only a small portion of elder adults are currently taking advantage of the
potential benefits offered by the social networking sites.

DOI: 10.1007/978-3-319-20892-3_29
298 J. Arfaa and Y.(Kathy) Wang
To investigate the possible reasons that led to the low social networking adoption of
the elderly, Arfaa and Wang [3] conducted a study with adults aged 65 and older using a
social networking site. The study showed that despite the low amount of users, elder
adults do have an interest in utilizing social networking site. Many elders expressed
wanting to view family photos and learn about current events through these types of
sites. However, the study also showed that unreadable text and image attributes and a
non-intuitive layout hindered the elders from these types of sites especially for those who
have little computer experience. In addition, Arfaa and Wang [2] evaluated the usability
and accessibility of a group of social media sites using both automatic tool as well as
manual verification. The result of this study concluded that many social networking sites
do not adhere to known web accessibility and usability guidelines such as Section 508
Compliance [10], WCAG 1.0 and 2.0 [13], Usability.gov [12], and the National Institute
of Aging [8]. This result further confirmed the barriers identified earlier.
In addition to usability and accessibility issues, when faced with a social networking
site without human support, many elders did not know where to start, were not aware of
the functionality offered on these sites, nor did they understand web 2.0 concepts. They
indicated that they would engage in more social media if it was easier to use [3].
Based on the results from the above studies, a redesign was undertaken to improve
the usability and accessibility of social networking sites for the elderly. This was
achieved by incorporating known guidelines and implementing additional consider-
ations focused on elder computer illiteracy and misconceptions [1]. Elder adults were
invited to utilize the redesigned website prototype and the results were compared to
their performance of a mock-up of a current social networking site.
This study investigates the following research questions: (1) Does the redesigned
prototype improve accessibility and usability for elder adults? (2) What tasks signifi-
cantly improved in terms of success rates and task performance? (3) How do the elders
perceive the newly redesigned site? Following this introduction the research method-
ology is described. Next, a brief overview of the newly designed networking site
prototype is presented. The results of the usability study are then discussed and
compared to previous phases of the study. The final sections discuss the findings and
future research areas that can be extracted by this study.
2 Methodology
Twenty-two elder adults aged 65 years and older participated in two usability study
sessions, one with the original design, another with the redesigned prototype. The
participants were recruited from personal connections and community centers and
chosen based on their age and computer experience. Elder adults were put into one of
two groups based on their self-reported level of computer experience: none-to-basic
experience group (group 1), intermediate to advanced experience group (group 2).
A baseline study was conducted before the design of the prototype to collect initial
data. The introduction of the study included its purpose and why the users were chosen.
Participants were asked to sign a consent form before the session began. The elder
adults performed a number of social media-related subtasks categorized into six main
tasks on a mock-up of the popular social networking site, Facebook. This site was
Usability Evaluation of a Social Networking Site Prototype 299
chosen based on its popularity and usage. Associated tasks included logging into an
account, understanding the homepage and profile, navigating and comprehending
information on a profile, and commenting on profiles. After completing all the tasks,
participants were asked to fill out a post-test questionnaire to comment on their
experience. After the design and implementation of the two versions of the prototype,
a final usability study session was conducted.
The same participants from the baseline study completed the similar set of tasks and
subtasks utilizing the redesigned prototype during the final usability study sessions. To
reduce bias from a learning effect by using both versions, the participants were ran-
domly assigned to start with version 1 or 2. Since a new social media learning com-
ponent was added in the prototype, a task regarding the learning of social media was
added to the original task list. Participants were asked to fill out a similar post-test
questionnaire which included questions regarding their experiences regarding the new
prototype. In addition, questions around social media learning were added to the
questionnaire.
During both study sessions, the researcher recorded observation notes including
task performance (success or failure in task completion), task completion time, and
additional observations while the participants performed the tasks. In addition, the
participant’s interaction with the system was captured using Camtasia [5]. Each
usability study session ran for about an hour for each participant.
3 Prototype Design Overview
The newly designed prototype took both the feedback gathered from the baseline study
and general usability and accessibility guidelines into consideration. This included
adjusting the contrast between background color and text, adjusting the font and its
size, and providing an intuitive layout that is easy to navigate. In addition, to
accommodate different website layout preferences (especially in the scenario that a
sub-navigation is required), elders were given two versions for the sub-navigation
placement. Version 1 consisted of the sub-links placed at the top and the second
version consisted of sub-links on the left-side of the page. Figure 1 is an example of the
two versions of sub-navigation for the Read Previous and Next buttons.
For both versions, the main content of the page was found at the center of the
screen.
Fig. 1. Top and side sub-navigation for read previous and next post arrows
4 Results
This section presents the data analysis conducted during the final usability study with
the newly designed social networking site interface prototype. The results in terms of
task performance success rates, completion time, and participants’ perception of their
experiences are discussed next.
4.1 Comparison of Task Success Rates

The following table shows the results of the baseline study compared to the final
usability study, categorized by computer experience groups: none-to-basic and
advanced-to-intermediate. The number of success attempts (success rates) for each
session and version are presented below (Table 1):
Table 1. Results of task performance based on previous computer experience

Task Frequency and Frequency and Frequency and
success rate success rate success rate
Baseline Final Version 1+ Final Version 2++
Group Group Group
1* 2** 1* 2** 1* 2**
Task 1: Logging 1 (9 %) 3 (27 %) 11 (100 %) 11 (100 %) 11 (100 %) 11(100 %)
into your account
Task 2: Understanding the 1 (9 %) 3 (27 %) 8 (73 %) 11 (100 %) 8 (73 %) 9 (82 %)
homepage
Task 3: Understanding your 0 (0 %) 2 (18 %) 2 (18 %) 8 (73 %) 4 (36 %) 3 (27 %)
profile
Task 4: Navigating through 1 (9 %) 1 (9 %) 8 (73 %) 10 (91 %) 8 (73 %) 9 (82 %)
the site
Task 5: Information on a 4 (36 %) 6 (55 %) 11 (100 %) 10 (91)% 9 (82 %) 8 (73 %)
profile
Task 6: Commenting on other 1 (9 %) 3 (27 %) 7 (64 %) 7 (64 %) 6 (54 %) 8 (73 %)
profiles
Task 7: Learning about social (N/A) (N/A) 8 (73 %) 10 (91 %) 9 (82 %) 11 (100 %)
media
* Group1: none to basic computer experience group
* Group 2: intermediate to advanced computer experience group
+ Version 1: sub-navigation on top
++ Version 2: sub-navigation on the side
Overall, both groups were successful in completing the tasks when using the rede-
signed prototype comparing to baseline study. For both groups, participants achieved the
highest success rate when logging into their account (task 1) no matter which version
they used. Majority of the participants (100 % in group 1, 91 % in group 2) in both groups
were able to complete tasks regarding understanding and comprehending information on
a profile (task 5) especially when they were using version 1. For group 2, all (11, 100 %)
participants were able to complete task 2, understanding the homepage, when using
version 1. In addition, when utilizing version 2, all participants from group 2 were able to
complete learning about social media. Conversely, task 3, understanding your profile,
had the lowest success rate for both group 1 when using both versions and group 2 when
using version 2. Both groups did have improvement in the performance on completing
these tasks compared to the baseline study.
4.2 Comparison of Final Group’s Completion Times

Each group’s average time to complete a task and standard deviation are discussed
next. Overall, both groups were successful in completing the tasks. Group 1 seemed to
have slightly higher performance than group 2 in only a few tasks (Table 2). When
using version 1 to complete tasks such as understanding the homepage (task 2), nav-
igating (task 4), and commenting on other profiles (task 6), participants in group 1 were
slightly faster on average than group 2. For version 2 group 1, logging into your
account (task 1) and understanding information on a profile (task 5) were also com-
pleted slightly faster on average than group 2. The faster times could be attributed to
the easy to understand layout. For example, a participant from group 1 noted during the
post-test questionnaire that “information was presented clearly and did not require [me]
to search” after using the newly designed interface prototype. Another elder stated that
buttons were in the general areas she expected to see them.
Table 2. Final usability study’s average completion time (Version 1 and Version 2)
Task Final Version 1 Final Version 2
Average Time for Average Time for
Completion in Completion in
Seconds (Standard Seconds (Standard
Deviation) Deviation)
Group 1 Group 2 Group 1 Group 2
Task 1: Logging into your account 1(0.0) 1 (0.00) 2 (3.39) 4 (4.79)
Task 2: Understanding the homepage 2 (1.30) 3 (3.85) 5 (5.57) 5 (5.39)
Task 3: Understanding your profile 3 (2.45) 2 (1.45) 6 (6.88) 4 (3.88)
Task 4: Navigating 1 (0.85) 2 (1.05) 4 (3.65) 2 (1.81)
Task 5: Understanding information on a profile 2 (1.25) 2 (1.37) 3 (4.02) 4 (3.88)
Task 6: Commenting on other profiles 3 (3.34) 5 (5.17) 5 (6.02) 3 (2.60)
Task 7: Learning about social media 2 (0.96) 2 (3.02) 4 (4.04) 3 (3.59)
4.3 Comparison of the Baseline and Final Version’s

Task Completion Times
In order to compare the impact of the different versions towards participant’s task
performance, each individual task was further extracted into subtasks. The Wilcoxon
test was used to find any significant difference between the performance data (subtasks)
in the baseline study and the two versions of the prototype used in the final usability
study. p values less than or equal to .05 were considered significant. Some significant
differences were found when comparing the baseline and final usability studies.
For example, when completing task 1, the subtasks of entering a username, pass-
word, and clicking the submit button improved when utilizing either version of the
redesigned prototype (Table 3). This could be attributed to separating the “sign-up” and
“login” links, larger header, and instructions added per the design considerations.
Table 3. Wilcoxon test: Comparing task 1 performance among three versions

Task 1: Logging into your account
Final V1/ Final V1/ Final V2/
Baseline Final V2 Baseline
Enter username
Z –2.402 .000 –2.402
p .016 1.000 .016
Enter password
Z –2.699 –1.342 –2.699
p .007 .180 .007
Click submit button
Z –3.053 –1.000 –2.836
p .002 .317 .005
Another example of a significant difference was when asking the participant to read
a post in the newsfeed (Table 4). Previously, during the baseline study many partici-
pants did not know they had to scroll to view additional posts. Many were not sure
where they could click to open the post. However, both versions of the final usability
study redesign implemented an intuitive “next” button shaped like an arrow. In addi-
tion, labeled buttons also let the participants know how to open a post.

Task 2: Understanding your
homepage
Final V1/ Final V1/ Final V2/
Baseline Final V2 Baseline
Read out loud the title of another
post in your newsfeed
Z –3.124 –.851 –3.317
p .002 .395 .001

Task 6: Commenting on other profiles
Final V1/Baseline Final V1/Final V2 Final V2/Baseline
Click on your friend Ann Jones to go to her profile page
Z –2.825 .000 –3.222
P .005 1.000 .001
Click where you would leave a comment on Ann Jones’ wall
Z –2.19 –.687 –2.505
P .028 .492 .012
The most significant changes based on completion times were the subtasks asso-
ciated with web 2.0 concepts, such as navigating to a profile page and leaving a
comment on one’s wall (Table 5). This is a major improvement, as the baseline study
elders could not locate the field to enter a comment. However, the redesign added
instructions and headings that clearly facilitated learning when the elders were inter-
acting with the redesigned prototypes.
4.4 Post-Test Questionnaire

After completion of the final usability study, participants answered a number of
post-test questionnaires regarding their experience using the newly redesigned social
networking site prototype.
Overall, the results were positive, with ten (91 %) participants from group 1 and all
participants (11,100 %) from group 2 stating the overall ease of use of the prototype
was easy to very easy (Fig. 2).
Ease of Use
18
16
14
12
10 Baseline
8
Final Study
6
4
2
0
Very difficult Difficult Neutral Easy Very Easy
Fig. 2. Questionnaire results: ease of use

64 % of the less experienced computer users and 55 % of the more experienced

computer users reported that they feel the text on the site was easy to read. In addition,
82 % of the less experienced computer group 1 and 100 % of the more experienced
computer group felt the site was intuitive.
5 Discussion
The objective of this study was to improve the usability and accessibility of social
networking sites for the elderly by redesigning the interfaces to accommodate this
aging demographic. Improving interfaces allows for increased accessibility and
usability for elder adults utilizing sites with Web 2.0 characteristics. Elder adults are
more inclined to utilize a site that has an easy-to-use interface that allows for learning
and support. This could lead to a more independent life for elders that are bound
logistically due to physical impairments. In addition, having social media incorporated
in their lives provides a medium to communicate with family, friends, and peers as well
as the ability to access a number of resources and stories.
In terms of the sub-navigation, the preference between the groups was different.
The participants in less experienced group preferred the side menu for sub-navigation
while majority of the participants with more computer experience preferred the
sub-navigation menu to be placed on the top of the screen. However, no conclusion on
the specific preference in terms of the placement of the sub-navigation menus could be
made, nor was a significant difference on the task performance between the final
versions found.
The tested prototype was implemented using current website design research,
existing guidelines, and additional social media usage feedback from the usability
studies [2, 3]. Elders were not left confused by interfaces or web 2.0 concepts and felt
comfortable completing tasks without assistance and intervention. A majority of the
participants enjoyed this study because they are interested in learning about computers
and social media. Many want to engage in social media activities to build relationships,
such as viewing photos, connecting with family and friends, and communicating
through email, instant message, and posts.
6 Limitations
During the usability sessions, the low number of participants limited the statistical
analysis that could be completed by the study; however, at least eight participants in
each group participated. The participant’s also did not demonstrate a wide range of
impairments, such as mobility, cognitive or vision issues. Therefore the findings may
not be able to be applied to a specific group. For example, an elder with eyelid issues
may not have the strength to look at different parts of a site, even though they expect to
find the activity or link in a particular location. Despite these limitations, the prototype
relied mainly on vision and involved minimal dexterity for completing tasks.
There were further limitations with the usability study. The participants could have
experienced a learning effect while completing the baseline study. This could lead to a
biased result as many of the elder’s participation was motivated by gaining exposure to
social media. Although this factor cannot be eliminated, the effect could have been
reduced as the two sessions took place three months apart.
7 Conclusion
The final usability session showed that the redesigned prototype improved the usability
and accessibility for elder adults. On almost every task, the times decreased for both the
novice and experienced computer group in comparison to the baseline session. In
addition, the results showed that 100 % of the elders preferred the newly designed
prototype versus the current social networking site.
Even though the more advanced group did perform better than the less experienced
group in general, their perception on the ease of use of the site was not significantly
different. This indicated that users’ previous computer experience and their perfor-
mance on the system did not influence their perception regarding social networking site
usage. Therefore, the interface design and features provided may not be the only factors
that can contribute to the actual use of a system. Instead, user’s attitude toward the
system may lead to their positive or negative perception of the system as well.
8 Future Work
Utilizing the newly designed prototypes, continued research with a larger and more
diverse sample is suggested. Diversity could include involving participants with more
diverse background. For example, recruit participants from a broader location, with a
larger and more categorized look of multiple elder age groups and physical impair-
ments. In addition, this research strictly focused on social networking site usage on a
laptop/desktop computer; however, many elder adults expressed their desire in using
tablets and other mobile technologies. Therefore, future studies could involve the trend
of social media websites and applications on mobile devices. In addition, a longitudinal
study could be conducted to look at the change in participant’s social media usage.
References
1. Arfaa, J., Wang, Y.: An improved website design for elders utilizing social media.
J. Technol. Persons Disabil. 51(6), 1173–1182 (2015)
2. Arfaa, J., Wang, Y.: An accessibility evaluation of social media websites for elder adults. In:
Meiselwitz, G. (ed.) SCSM 2014. LNCS, vol. 8531, pp. 13–24. Springer, Heidelberg (2014)
3. Arfaa, J., Wang, Y.: A usability study on elder adults utilizing social networking sites. In:
Marcus, A. (ed.) DUXU 2014, Part II. LNCS, vol. 8518, pp. 50–61. Springer, Heidelberg
(2014)
4. Brenner, J.: http://pewinternet.org/Commentary/2012/March/Pew-Internet-Social-Networking-
full-detail.aspx
5. Camtasia: http://www.techsmith.com/camtasia.html
6. Facebook. https://www.facebook.com/
7. Google+. https://plus.google.com/
8. HHS. http://www.hhs.gov/web/508/contracting/hhs508policy.html
9. LinkedIn. http://www.linkedin.com/
10. Section 508.gov. http://www.section508.gov/index.cfm?fuseAction=stdsSum
11. Susanta, M., Bagchi, I., Bandyupadhyay, A.: Design of a data model for social network
applications. J. Database Manage. 18(4), 51–79 (2007)
12. Usability.gov, Guidelines (2012). http://www.usability.gov/guidelines/index.html. Accessed
13 Dec 2012
13. Web Content Accessibility Guidelines (W3C). http://www.w3.org/WAI/intro/wcag
ICT Access in Libraries for Elders
Amrish Chourasia1(&), Jim Tobias2, Steve Githens3, Yao Ding1,

and Gregg Vanderheiden1
1
Trace R&D Center, University of Wisconsin-Madison, Madison, USA
[email protected], [email protected],
[email protected]
2
Inclusive Technologies, Matawan, NJ, USA
[email protected]
3
Raising the Floor, Washington, DC, USA
[email protected]
Abstract. The ability to use information and communication technologies

(ICT) is becoming a necessity. Older users are one of the fastest growing seg-
ment of ICT users but many still face barriers in ICT use. Libraries are one of the
first places that individuals turn to when looking for information or assistance
with ICT. Libraries also serve as an important resource for individuals to access
the Internet. However, libraries face several problems in providing services to
elders. Lack of funding and trained staff, insufficient knowledge about acces-
sibility prevents them from successfully serving their patrons. We present the
Library-GPII-System, a cloud based auto-personalization system that will enable
libraries to successfully serve their older patrons. Results from our library
stakeholder needs analyses are also presented.
Keywords: Libraries Auto-personalization Cloud infrastructure Assistive

technology Access features
1 Introduction
The ability to use information and communication technologies (ICT) is considered a

pre-requisite to living in the information age [1]. Older users are a group that has shown
impressive growth in Internet adaption but several barriers still exists for older users.
Public libraries have recognized the need for providing better ICT services to older
adults and guidelines have been developed for this purpose. However, numerous
challenges exist for libraries to serve older adults successfully. We present an approach
to reinvent accessibility in libraries to promote use of ICT by older users.
There have been numerous and continuous efforts by governments to promote
widespread Internet use [2, 3]. However, there still exists a digital divide, a gap
between those who have access to ICTs and those who do not. Determinants of the lack
of access to ICTs include: income, disability, race, gender, and age [4, 5].
Although a lower percentage of older adults use the Internet than younger adults,
older adults are the fastest growing segment of Internet users [6]. Some of the barriers
to Internet use by older adults are: perceived lack of benefit, lack of interest or moti-
vation, lack of knowledge, lack of access, cost, fear of hardware being outdated
DOI: 10.1007/978-3-319-20892-3_30
308 A. Chourasia et al.
quickly, and perceived barriers due to physical limitations [7]. The aging process
results in physical and cognitive changes that have implications for ICT use by some
older adults [7]. Some of the physical changes include declines in vision, hearing, and
motor control [7, 8]. Cognitive changes include general slowing of cognitive processes,
decreased memory capacity, decreased attentional control, and difficulty in goal
maintenance [9]. Strategies such as larger targets, longer timeouts, and less complex
interfaces have been recommended [8].
Public libraries play an important role in providing various services to the elderly
[10]. Since 1970 the American Library Association (ALA) has issued guidelines on
providing services to older adults. These guidelines encourage collecting data about the
older population and including the needs and interests of the older adults in library
programming [11]. Libraries are also the home of many digital literacy programs that
are aimed at seniors.
The transition to electronic library resources necessitates that electronic accom-
modations for older adults are available. However, providing such accessibility services
is outside the scope of many libraries due to a combination of factors such as reduced
budgets, lack of expertise in providing electronic accessibility services, lack of control
over IT environment, and expensive assistive technology (AT). Libraries that intend to
serve whomever comes through the door cannot know in advance what those needs
might be, nor how frequently the needs will arise.
What is needed is a solution that: (1) makes access to library materials and
equipment much easier (for staff and patrons) to set-up and use; (2) meets the needs of
patrons with very diverse needs and abilities in an affordable manner for libraries large
and small; (3) makes materials and services accessible on demand so that any
material/service that a person needs can be made accessible on demand; (4) sets up a
workstation instantly not just with the type of AT a person needs, but with that user’s
AT settings, each time they come in; (5) enables diverse AT to work integrally with the
ICT systems in libraries, in a stable and secure manner; and (6) allows libraries to keep
up with the rapid change of assistive technologies and access features in their main-
stream technologies without excessive investments in time or money.
2 The Library-GPII-System
The Library-GPII-System (LGS) aims to provide the above capabilities to libraries.

The LGS will represent the first real-world application of the Global Public Inclusive
Infrastructure (GPII). The GPII (http://www.gpii.net) is an initiative of the Raising the
Floor Consortium and aims to utilize cloud computing to create the infrastructure to
enable AT, mainstream and other service providers to provide affordable assistive
services whenever and wherever a user demands them. The GPII will enable people to
• learn about and determine what solutions will assist them
• store that information in a common, portable, private and secure manner;
• use the stored preferences to invoke and configure needed accessibility and usability
features, assistive technologies on any device they encounter; and
• provide tools and infrastructure to developers and vendors to create new solutions
for different users in a cost effective and efficient manner.
ICT Access in Libraries for Elders 309
The European Union funded projects, Cloud4all and Prosperity4all are currently
underway helping build the GPII along with the Fluid and Floe projects and
UIITA-RERC.
The LGS is a five-year project that is part of the GPII work being done by the
Rehabilitation and Engineering Research Center at the Trace Research and Develop-
ment Center at the University of Wisconsin-Madison. The LGS will be developed,
implemented and evaluated in three phases:
1. Needs Analysis – work with stakeholders to define the needs, constraints and
specifications for the LGS (2013-2014).
2. LGS Development and User Testing (2014-2016).
3. Empirical Field Testing of the LGS in Libraries (2017-2018).
We have results from the first phase and these inputs are currently being used to create
prototypes of the LGS.
3 Needs Analysis Results
3.1 Public Library Services and Their Needs

Public libraries perform a wide range of services, not all of which are relevant to this
study. The four that are most relevant are access to materials, Internet access, e-books,
and technology training.
Access to Materials. Finding and getting books and other resources is still the primary
service of public libraries. There are two parts to this function, both of which are still
undergoing their transitions to digital technologies through what are typically called
integrated library systems (ILS): catalog operations and check-out/check-in. Library
searches are no longer restricted to items found within the walls; this applies to virtual
resources as well as inter-library loan. To follow this trend, catalog systems are being
re-envisioned as discovery systems, allowing patrons to search for all kinds of
resources. On the administrative side, ILSs allow librarians to add items to their col-
lections, track usage, notify patrons of due dates, etc. A larger percentage of transac-
tions are being performed electronically, including holds, renewals, and in-person
check-in and check-out at kiosks. The usual form of identification is the barcode on a
library card. Off-site, libraries use both the library card ID number (often with a default
PIN of its last 4 digits) and login/password pairs created by the patrons themselves. All
libraries offer access to online databases, often through regional or state contracts [12].
These include periodicals, language learning, and other educational resources.
Internet Access. Virtually all public libraries offer Internet access on library machines;
98 % also offer WiFi to patrons bringing their own devices [12]. 62 % of public
libraries provide the only free access to the Internet in their communities.
Libraries average about 20 computers per location, with city libraries double that
and rural about half [12]. 65 % of libraries report having an insufficient number of
public computers to meet demand; this increases to 87 % in urban libraries. 36 % report
that they have waiting periods every day. In order to manage this problem, libraries use
software to create waiting lists and limit time on workstations. About one-third of
library computers are 4 years old or more [12].
E-books. E-book usage is growing rapidly. 90 % of libraries now offer access to
e-books [12], 92 % of urban libraries, compared to 65 % of rural libraries. 39 % of
libraries provide e-readers for checkout by patrons; other libraries load e-books onto
patron-owned devices or provide readers for on-site usage only. 97 % of libraries use
Overdrive to manage their e-book collection.
Technology Training. Public libraries appear to be the community technology
training resource of first and last resort; 98 % offer technology training, though not
always formal training [12]. This includes, but is not limited to, digital literacy.
Libraries report that training usage continues to grow. A surprisingly small number
(28 %) offer online training materials, this in the face of well-funded national cam-
paigns to develop and distribute such materials. 44 % offer their own in–person
training. Most notable is the role of one-on-one instruction. More than a third of all
libraries offer such personal attention, by appointment. In addition, more than 80 %
offer informal point-of-use assistance.
3.2 Accessibility in Public Libraries

To understand the current state of accessibility services in public libraries, we con-
ducted a survey with a convenience sample of 18 public libraries. Questions in the
survey were divided in two categories. The first set of questions was related to the
information technology network in the libraries and their user account management and
policies. The second set included questions about the AT software and hardware,
accessibility of library media, website and outreach efforts. The results from the second
set of questions are included below (Tables 1, 2 and 3).
Table 1. Survey results about availability of AT software in public libraries

No. Question Response
At software
1 Do you have screen readers for users who are blind? Yes = 4
No = 14
2 Do you have screen readers or highlighters for users with other Yes = 4
reading disabilities? No = 14
3 Do you have screen magnifier software? Yes = 11
No = 7
4 Do you have on-screen keyboard or other input software? Yes = 3
No = 15
5 Do you have speech recognition software? Yes = 0
No = 18
6 Do you have software for text relay or video relay service? Yes = 1
No = 17
(Continued)
Table 1. (Continued)
At software
7 Do you have any tools for people with cognitive or learning Yes = 1
disabilities? No = 17
8 Do you have alternative communication software for people who Yes = 1
do not speak? No = 17
9 Are these packages available on only a subset of workstations, or All = 1
on all workstations? Subset = 1
N/A = 15
10 How do you currently license these packages? [single user, site Single user = 6
license] Site
license = 0
Mixed = 1
N/A = 11
11 Do you permit patrons with disabilities to use their own AT (e.g., Yes = 5
portable AT software, typically on a thumb drive)? No = 7
Undecided = 2
Don’t
know = 4
Table 2. Survey results about availability of AT Hardware in public libraries

At hardware
1 Do you have special keyboard, trackball, switches, or other input Yes = 6
device? No = 12
2 Do you have a camera for sign language communication? Yes = 0
No = 18
3 Do you have any CCTV or other electronic magnifier device? Yes = 7
No = 11
4 Do you have any scanner/optical character recognizer? Yes = 6
No = 12
5 Do you have a Braille printer or electronic braille device? Yes = 0
No = 17
Don’t
know = 1
6 Do you have assistive listening devices? Yes = 5
No = 13
Table 3. Survey results about accessibility of media materials in public libraries

Media
1 Are any videos in your collection captioned? Yes = 18
No = 0
2 About what percentage of your collection (rough estimate)? <=50 % = 1
> 50 % = 6
Don’t
know = 9
3 Are any videos in your collection audio described? Yes = 3
No = 10
Don’t
know = 5
4 About what percentage of your collection (rough estimate)? <=50 % = 1
Don’t
know = 4
NA = 13
5 Do you have videos in your collection for people with cognitive Yes = 3
disabilities, such as life skills videos? No = 14
Don’t
know = 1
6 About what.% of your collection (rough estimate) 5%=1
NA = 14
Don’t
know = 3
7 For all: are they indexed so patrons can search for them in your Yes = 11
catalogue system? No = 5
Don’t
know = 2
Results of our library survey reinforce that there is a shortage of assistive tech-
nologies and media in public libraries and a solution that addresses accessibility on
different levels is needed.
4 LGS Development
The development phase of the LGS project is currently underway and will last through
the end of 2016. For the development process, we have recruited six different library
partners (four public libraries and two university libraries). The first version of the LGS
will allow users to activate Windows access features and the NVDA screen reader
using near field communication (NFC) tags. Subsequent versions of the LGS will allow
users to create their own needs and preferences for the supported access features and
assistive technologies. Through 2015, Read&Write Gold, JAWS, and other AT

requested by our development partners will be integrated with the LGS. Other AT is
also being integrated through the Cloud4all project and will also be included in the
future versions of the LGS. Software developers are invited to integrate the applications
with the GPII.
4.1 Integrating Applications in the LGS

Developers can easily integrate their applications with the GPII. To integrate appli-
cations in the GPII it is necessary to understand the overall GPII architecture (see
Fig. 1). A detailed description of the architecture can be found here: http://wiki.gpii.net/
w/A_Detailed_Tour_of_the_Cloud4all_Architecture.
Fig. 1. The Cloud4all/GPII architecture
The different components of the GPII architecture are [13]:

1. Flow Manager: The Flow Manager is a event-driven, asynchronous orchestrator of
the personalization workflow. Currently, it is implemented as a very small web
server that runs on the local device and is responsible for bringing together the
various components in the system and invoking them at the appropriate points in the
process. In the future, some of the Flow Manager’s responsibilities will be dis-
tributed between both the local device and the cloud.
2. User Listener: The User Listener kicks-off the process of customizing a device or
application to the user’s needs and preferences. The user shares their key with the
listener, which then starts the personalization process. The key can be a unique,
random key or a personal ID based on user preference. Currently, a RFID and a
USB user listener are available.
3. Preferences Server: The Preferences Server is a web-based service that provides a
REST API for accessing preferences in a JSON format. Preferences will be rep-
resented according to a new version of the AccessForAll ISO 24751 standard.
4. Device Reporter: The Device Characteristics Reporter provides information about
the user’s device. This includes operating system, versions, and the list of appli-
cations currently installed. It will also provide information about the device’s
capabilities, such as screen resolution and size, support for features such as
HTML5, and the availability of devices such as microphones and cameras, etc.
5. Matchmaker: The matchmaker considers the user’s preferences, applications
available on the user device and the environmental context to determine which
solutions and settings best meet the user’s needs. Upon invocation by the flow
manager, it returns a list of solutions and settings, which is passed to the lifecycle
manager.
(a) Solutions Registry: The matchmaker gets the list of local and cloud based
solutions available for a user from the solutions registry.
6. Lifecycle Manager: The Lifecycle Manager receives the list of appropriate solutions
and settings from the Matchmaker and manages the process of setting them up using
the lifecycle and settings handlers.
(b) Lifecycle handler: It is a function that
(i) Take a snapshot of the device’s current settings, so they can be restored
later
(ii) Invokes the Settings Handler appropriate for each solution
(iii) Launches each solution
(iv) Stops each solution when the user is done
(v) Restores the previous settings (if required) once the user is finished.
(c) Settings handler: It is a type of a lifecycle handler that is responsible for
configuring the settings of an application, access feature or AT. Settings
Handlers typically interface with the operating system’s built in APIs for storing
settings (such as the Registry on Windows and GSettings on Linux). Settings
Handlers are configured declaratively, and assistive technology developers will
typically use the ones that are built in to the system. If the default settings
handlers are not sufficient, developers can create their own. The follow settings
handlers are available in Cloud4all/GPII by default.
(i) XML files
(ii) JSON Files
(iii) Linux GSettings
(iv) Linux DBus
(v) Windows Registry.
(vi) Windows SystemParametersInfo.
In order to register their software that runs on a platform like Windows or Linux, with
the Solutions Reporter, developers need simply to create a standard JSON file called a
Solutions Description, which will contain [14]:
• name (string): The name of the application/solution in a human readable format.
• id (string): A unique ID for the application. The general format used is the Rever-
se-DNS notation (e.g. “com.microsoft.win7.magnifier”)
• contexts (object): Describes the context required for this solution to be applicable.
(e.g. which platforms are supported)
• lifecycleManager (object): Instructions for the Lifecycle Manager describing what
should happen to launch or quite an application or when a user logs in and logs out.
• settingsHandlers (array): An array of settings handlers (and their settings) that
should used to configure this solution (If the product stores its preferences in a
standard way for the platform, then these handlers will already exist in the GPII.)
• Ensure that all preferences are registered in the GPII Preference Terms
Dictionary/Registry. (The GPII team will help with this.)
After creating the solutions description, developers write an acceptance test. In this
context, an acceptance test involves testing the entire real-time “auto-personalization
from preferences” framework end to end. The test starts with the user using a Key-
Token to invoke their preferences from the preference server, and then checking that
each possible preference is set appropriately in the target product under test. The they
user is keys-out and again a check is made to ensure that all the settings on the target
product are returned to their original state. This means that the actual system will be
configured (and restored) when running the acceptance tests.
Examples of how to integrate native and web based applications with the GPII can
be found at and http://blogs.cloud4all.info/developers/.
5 Next Steps
The development of the LGS will be completed in 2016. Subsequently the LGS will be
deployed in at least four libraries that are not development partners, some of which will
not have any previous connection to accessibility, in the effort to assess the impact of
the LGS on library accessibility practices. A certain number of additional libraries will
also be allowed to implement the LGS as possible. Feedback from these libraries will
also help us develop guidelines for implementation of the LGS in other libraries.
6 Conclusion
Libraries face a number of problems in providing services to the elderly and those with
disabilities. The problem is becoming more acute with continued lack of funding for
expensive solutions and accessibility training. The LGS represents a solution that can
help libraries address the problems on multiple fronts. The development of the LGS is
currently underway and software developers are invited to integrate their solutions with
the LGS.
Acknowledgement. Different components of the body of work described in this paper was,
and/or is being, funded by the European Union’s Seventh Framework Programme
(FP7/2007-2013) grant agreement n° 289016 (Cloud4all) and 610510 (Prosperity4All), by the
National Institute on Disability, Independent Living, and Rehabilitation Research, US Dept of
Education and the Administration for Community Living under Grants H133E080022
(RERC-IT) and H133E130028 (UIITA-RERC) and contract ED-OSE-12-D-0013 (Preferences
for Global Access), by the Flora Hewlett Foundation, the Ontario Ministry of Research and
Innovation, and the Canadian Foundation for Innovation. The opinions and results herein are
those of the authors and not necessarily those of the funding agencies.
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Examining the Validity of the Banner
Recommendation System
Rong-Fuh Day(&) and Chien-Ying Chou
Department of Information Management, National Chi-Nan University, Nantou,

Taiwan, ROC
{rfday,s101213511}@ncnu.edu.tw
Abstract. The phenomenon of banner blindness has concerned researchers,

advertisers and website publishers during these years. In order to alleviate the
phenomenon, this study attempted to develop a banner recommendation system
which could arrange banners according the relative salience of keywords on a
webpage viewed by a user. The prototypical system are being developed,
however, we have made an initial examination on the effectiveness of its banner
recommendation functionality. It was found that two recommendation accura-
cies for the system calculated with two different criteria both were significantly
higher than the probability by chance.
Keywords: Banner blindness Recommendation system Eye tracking

approach
1 Introduction
Currently, the Internet is one of the key channels for advertisements. However,
researchers, advertisers and website publishers have observed that web users would
intentionally ignore web advertisements and even some of editorial components that
resemble online advertisement in shape, without determining the editorial component’s
content. This phenomenon is referred to as “banner blindness” [1–4]. Researchers and
relevant practitioners are generally concerned that the long-term continuation of the
status quo would substantially reduce the effectiveness of Internet advertisement
communication and hinder efficient market operations. In recent years, numerous
studies have examined the causes of banner blindness to identify an effective adver-
tising method for communicating with consumers.
Previous studies have reported that Internet advertisements are ignored because
Internet users demonstrate high goal- and task-oriented characteristics. In contrast to
traditional media, Internet users often employ the Internet media for completing a
specific task. In these circumstances, Internet advertisements frequently interfere with
the ongoing work of the users, causing advertising irritation and avoidance [5–8].
Internet users eventually develop a habit of simply ignoring online advertisements.
These findings further solidify the importance of personalized advertisements. We
assert that if advertisements are arranged based on the current objective or needs of web
users, advertisements are likely to provide users with a utility that yields additional
benefits. Long-term application of this strategy may gradually reverse the banner
DOI: 10.1007/978-3-319-20892-3_31
318 R.-F. Day and C.-Y. Chou
blindness phenomenon and entice users to pay attention to and understand the mes-
sages conveyed in the advertisements.
Personalized advertising has been an attractive concept; however, developing such
a system is extremely complex [9]. The first challenge is determining how to auto-
matically detect the purpose, needs, and preferences of browsers and use these data as a
basis for advertisement arrangements. This study proposed a solution approach by
employing an eye tracker for observing browser’s viewing behavior on webpages, and
thereby enabling the system to analyze the preferences of browsers as well as to
recommend relevant advertisements to be presented to them based on the results of the
analyses. The reason for applying the eye tracker is that the eye-tracker has been
considered a precision apparatus which can provide real-time and fine-grained eye
movement data for investigating underlying cognitive processes [10–16].
In this study, we developed an advertisement recommendation system based on the
concept described previously. Furthermore, we conducted an experiment for verifying
the accuracy of the advertisements recommended by the system. In the subsequent
sections, we discuss our theoretical basis, experimental procedures, and experimental
findings.
2 Literature
2.1 Personalization
Personalization has been an important and appealing idea in the development of
information systems. Personalization emphasizes that the information systems is
capable of adjusting its functionality, screen layout, and content…etc. According users’
needs and preferences [17, 18]. Based on the idea, researchers and practitioners have
developed various kinds of personalized services on the Internet. For example, Liu etc.
[19] developed a news recommendation system, which could recommend readers the
news which they might be interested in. Davidson etc. [20] developed a video rec-
ommendation system on YouTube, which could suggest users videos that are worth
watching. The production recommendation system, which can suggest the productions
buyers might like, has been common on todays’ shopping sites, such as Amazon and
e-bay. However, one general challenge such recommendation systems face is that how
to infer users’ needs and preferences. Therefore, efforts many researchers have been
devoted are to find out potential meanings from traces which users leave when they
browse websites.
One general method for inferring user’s interests is through analyzing the char-
acteristics of the content of webpages which an user has viewed. The approach is
termed the content-based prediction, assuming that the content itself can manifest the
interests of users. The approach has been further developed to a collaborative method,
which takes into consideration the content which other people have viewed [17, 21].
Another approach for inferring user’s interests is through analyzing users’ behav-
iors of using webpages. When viewing webpages, users’ explicit and implicit activities
can be logged. The explicit activities are users’ responses to a questionnaire about
“like” or “unlike”. The implicit activities includes the duration of viewing a webpage,
Examining the Validity of the Banner Recommendation System 319
scrolling down, zoom in and out, click, etc. [18, 21–25]. Although the explicit activities
can be the most immediate relevant to users’ interests, they could put much loading on
users, thus making it unfeasible. In practice, the usage of the implicit response is more
feasible. In this study, the eye tracking technology is applied to capture users’ ocular
activities, which can be considered as a kind of implicit activity.
2.2 Eye-Tracking Technology

During recent years, the eye-tracking technology has become feasible in our daily life,
for example, Semsung S4 smart mobile phone has been equipped the eye-tracking
technology using the camera embedded on the mobile phone. This provides several
interesting applications, such as detect whether a user is looking at the screen in order
to decide whether to continue playing a movie. Similar low-cost and effective eye
tracking technologies have been developed with the webcam mounted on the desktop
and laptop.
In general, the eye-tracking technology can provide real-time data about a variety of
eye-movements, such as the location of eye fixation, the duration of eye fixation, and
the pupil size of eye fixation. For the development of personalization system, the eye
movement data is valuable in two ways. Firstly, the eye fixation can infer what an
individual is processing in his/her working memory. According to the eye-mind
assumption of Just and Carpenter [14, 26], what an individual is looking at is what s/he
is processing. Their assumption has been supported by following research particularly
in the field of reading [15, 16, 27]. In a broader sense, the location of fixation also
manifests where an individual gets interested in. In addition, the fluctuation of pupil
size is an immediate sensitive index about the arousal state of individuals and reflects
individual’s preference [28, 29]. Secondly, when viewing a webpage, the eyes gen-
erally keep capturing the information on the webpage, even when mouse and keyboard
activities are stopped. Therefore, this study considers that the eye movement has a great
potential to become an important implicit behavioral cue other than click to improve
the prediction of users’ needs and preferences. This study contributes to lead a better
personalization.
3 Experiment
3.1 Participants
We recruited 56 college and graduate students at National Chi-Nan University, Taiwan,
aged between 18 and 25, who voluntarily agreed to participate in this study as our
formal study participants. After the experiments were completed, each participant
received NT$150 as a reward. In addition, prior to the formal experiments, additional
eight participants participated in a pilot test to determine necessary improvements for
the system and the experiment process.
3.2 Stimulus
The experimental stimulus was an article that introduces the functions of three brands
of digital cameras: Apple, Nokia, and Canon. In this article, the number of times that
the three brand names appeared in the article is identical. We presented the contents of
this article on six linked subsequent web pages. Regarding the design of web page
layout, except for the first Web page that comprised only the main editorial area, web
pages 2 to 6 contained an advertisement banner above the main editorial area (Fig. 1).
Fig. 1. The left picture illustrates the layout of the webpage first viewed by the participant, and
the right illustrates the layout of the remaining experimental webpages.
3.3 Experimental System and Eye Tracker

We integrated the experimental system with the EyeLink II eye tracker function. The
system features a web browsing function and can simultaneously analyze the number
of fixations on the three brand names on the web pages. Second, when the participants
want to browse the next web page, the experimental system identifies the brand name
that received the most fixation points and places the advertisement banner corre-
sponding to this brand on the next web page. Finally, the system records the adver-
tisements that were recommended to each participant.
The EyeLink II is manufactured by SR Research and has an eye sampling rate of
5000 Hz/s. This system has high accuracy, an average gaze position error of < 0.5°, and
can provide real-time sampling data at a data latency of only 3 ms.
3.4 Questionnaire
In order to estimate the accuracy rates of advertisement recommendation for the
experimental system, we designed the following two questions as comparison criteria
and asked the participants to answer them after the experiment. Question 1 pertains to
subjective experience with the allocation of fixations: “When you were browsing the
web pages, the Apple, Nokia, and Canon brands appeared in the pages. Which of these
brands did you pay more attention to?” Question 2 pertains to prior brand preferences:
“Among the Apple, Nokia, and Canon brands, which on were you more interested in
before you browsed the web pages?”
3.5 Experimental Procedure

Only one participant engaged in the experiment at a time. Before the experiment
commenced, a brief description of the purpose and procedure of the experiment was
presented to the participants and their questions about the experiment were answered.
First, the laboratory assistant placed the headband of the eye tracker on the head of the
participant and calibrated the eye tracker accordingly. The entire 5–10 min. The lab-
oratory assistant then give the task instruction to the participant as follows: “Imagine
that you wish to purchase a digital camera on the Internet and found an online article
that introduces the functions for three brands of cameras. You are about to begin
reading the Web pages that you found.” The experiment program was then activated,
and the participant began reading the Web pages and had to click the “next page” link
to read the next page. After all of the Web pages were read, the laboratory assistant
assisted the participant with removing the headband of the eye tracker and asked the
participant to answer the questionnaire. Subsequently, the reward was given and the
purpose of the study was explained to the participant.
4 Data Analyses
Data were collected from a total of 56 participants after the experiment. First, we
examined the eye movement data for each participant. If the eye movement data
deviation was exceedingly large and could not be calibrated, we deleted the data of this
participant. After this process was completed, data from a total of 44 participants were
valid for subsequent analyses.
Next, we calculated the system advertisement recommendation hit ratio based on
the participants’ responses to the questions regarding subjective experience with the
allocation of fixations and prior brand preferences. The attained hit ratios was used as
an accuracy indicator. The method by which hit ratio was calculated is explained as
follows using the prior brand preferences as an example. During the experiment pro-
cess, the experimental system recommended five advertisements to each participant. If
a participant answered “Apple” on the prior brand preferences question, the recom-
mendation correctness was defined as 1, 0.5, and 0 if the system recommended the
Apple advertisement three times or more, two times, and one or zero times, respec-
tively. Eventually, we derived the average accuracy for the 44 valid experiments to
represent the accuracy of the advertisement recommendation for the experimental
system. This method is similar to using a confusion matrix for calculating the hit ratio
[30, 31].
The final results obtained are as follows: (a) The recommendation accuracy for the
experimental system was 0.488 according to the participants’ response to the ques-
tionnaire about subjective experience with the allocation of fixations. (b) The recom-
mendation accuracy for the experimental system was 0.443 according to the
participants’ response to the questionnaire about prior brand preferences. Both of the
accuracy were significantly higher than the probability of (1/3) * 1.25 = 0.41 by
chance.
Based on the rationale that people’s preference can be manifested in their viewing, this
study analyzed participant’s fixation on the brand keywords on the web pages to infer
participant’s current brand preference while viewing the web pages, and used this
inference as a basis for recommending web advertisement in a real-time manner. The
results of this study indicated that the advertisement recommendation accuracy of the
experimental system was significantly higher than that by chance. Therefore, we
suggest that this method can serve as a basis for further developing an advertisement
personalization system in the future. Several directions are suggested for future
research. First, future studies can attempt using other machine-learning methods, such
as the neural network, for analyzing the viewing behavior of web page to gain better
prediction to user’s preference. Second, an instant feedback mechanism can be
developed for determining whether recommended advertisements satisfy user’s current
preference, and the results can serve as a reference for tuning the recommendation
system.
This study has several limitations that must be addressed: First, this study only used
one scenario (purchasing a camera) to validate the performance of the recommendation
system. Second, we did not examine whether the recommended advertisements attract
user’s attention. Future research can address with the issue on the effectiveness of the
recommended advertisements.
5.1 Limitation and Future Research

When interpreting the results, the reader should be aware of certain limitations. First,
the layout of the experiment follows the typical webpage design, however, it has a little
limitation in ecological validity. Second, in order to increase the ecological validity of
our experiment, the brands used in this study, such as, Apple, Nokia, and Canon, are
real in our daily life. The reader should be aware of that the manipulation would
introduce some unexpected confounding factors into our findings. Thirdly, in the
experiment, the eyetracker was mounted on the head of the participants. The partici-
pants would have some uncomfortable sensations in their head especially when they
took a longer time to finish the experiment. This fatigue factor might confound the
experiment results. In future research, we suggest the researchers to replace the
mounted tracker with the remote eyetracker, which can be mounted under the screen, in
order to decrease the loading of experimental participants. Finally, future research
might develop other index on ocular behavior to validate the effectiveness of the
recommendation system. In addition, the triangular validation can be applied to
examine the developed ocular index with other traditional advertising measurements.
Acknowledgements. This research is sponsored by the NSC of Taiwan, grant no.

102-2410-H-260-038- and 103-2410-H-260-038 -.
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Conducting Acceptance Tests for Elderly
People on the Web
Using the GPII Preference Set for a
Personalized Evaluation
Alexander Henka1(&), Andreas Stiegler1, Gottfried Zimmermann1,

and Thomas Ertl2
1
Stuttgart Media University, Stuttgart, Germany
{henka,stiegler,gzimmermann}@hdm-stuttgart.de
2
Institute for Visualization and Interactive Systems (VIS),
University of Stuttgart, Stuttgart, Germany
[email protected]
Abstract. Due to the overlapping requirements with people with disabilities,

elders can benefit from accessible web design and the use of assistive tech-
nologies. But elderlies face also semantic problems that are derived from dif-
ferent perception models or the mere anxiety of using new technologies, which
can’t be evaluated by accessibility guideline conformance only. Tackling those
semantic issues calls for more user-centered evaluation. The Global Public
Inclusive Infrastructure (GPII) provides user interface adaptation based on
peoples individual needs and preferences. These preferences are stored in
so-called preference sets and can also contain sematic settings. In this paper, we
propose an accessibility evaluation method, using the preference sets of the GPII
to derive authentic accessibility requirements. Hereby, we’re able to carry out
tests according to guideline conformance and semantic requirements. In this
context, we propose a personalized accessibility evaluation approach based on
original user preferences that addresses the need for a user-centered evaluation.
Keywords: Human computer interaction Accessibility Elderlies Acceptance

tests Web accessibility guidelines GPII User-preference set User-centered
accessibility evaluation Technical accessibility Semantical accessibility
1 Introduction
The accessibility requirements of web applications for elderly people are similar to the
requirements of people with disabilities. Typical issues are related to vision, cognition
or motor coordination constraints [1–3]. Therefore, accessibility guidelines (e.g.,
WCAG 2.0 [18]) can be used as one approach to evaluate the accessibility of a web
application for elderly people, as it was indicated in [2, 4, 5], but are not sufficient, as
suggested by Affonso et al. [2]. They advocate an extension to the WCAG 2.0 to meet
specific accessibility requirements of elderly people. Based on their research, Pernice,
Estes and Nielsen [19] have generated a set of guidelines that is specifically tailored to
“senior citizens” on the Web.
DOI: 10.1007/978-3-319-20892-3_32
326 A. Henka et al.
Elderly users however, are frequently confronted with issues that cannot be iden-
tified by merely checking the conformance of an application to guidelines. These issues
result from mental models that differ between designers and users, and from differences
in strategies for the meaning making and problem solving process [6]. Those diffi-
culties are not considered accessibility related issues in the general understanding of
accessibility evaluation, according to guideline conformance, but need to be tackled in
the application’s design [2, 4]. Age-related disability issues also tend to change over
time and new or additional impairments can arise [4, 7]. This calls for a constant
tracking and adaptation of accessibility requirements for ICT products.
Studies [8–11] advocate for a strong User Centered Design approach, in which
testing for web accessibility can benefit from existing work in usability evaluation.
Furthermore, they suggest that accessibility in general is strongly user-centered. Bar-
riers occur when there is a mismatch between a user and a web application in terms of
interaction characteristics. Brajnik [8] characterizes accessibility in a user-centered
context: “[Accessibility is, when] specific users with specific disabilities can use it [the
software] to achieve specific goals with the same effectiveness, safety and security as
non-disabled people”. According to this understanding, a barrier is a condition, which
prevents a specific user, who has specific traits and is using specific assistive tech-
nologies, from achieving their specific goals.
Hence, a barrier is an attribute of the interaction between the user and the system,
and the occurrence depends therefore on the user, the situation and the system.
A barrier is defined by: The user and their specific traits, the assistive technologies
being used, the goal(s) of the user and the properties (defects) of the web application,
which, taken together, prevent the accomplishment of the goals. In consequence,
conformance tests are not sufficient to fully clarify the accessibility of a web appli-
cation, as discussed in [12, 13]. The conformance to accessibility guidelines is a
technical property of the website and does not take the specific traits of the user, their
devices and assistive technologies into account. Hence, when checking the accessibility
of a web application, it is important to take the perspective of the end user, i.e. in a way
that reflects how an end user would interact with the system [10].
It was stated that especially the elderly often encounter barriers on the web, which
can’t be determined by guideline conformance [2, 4, 6]. These issues originate mostly
from the field of bad application design or usability flaws [2, 4]. To achieve accessi-
bility, especially for elderly people, one must not only guarantee guideline confor-
mance, but also the usability and understandability of a web application; therefore, we
have to consider technical and semantical accessibility.
Technical Accessibility. Describes the conformance of an ICT product to accessibility
guidelines. Even if guideline conformance is accomplished, there is no guarantee that
this will result in an accessible product. Accordingly, accessibility-testing tools, which
rely on guideline conformance only, can’t ensure the accessibility of a product, if web
applications are just designed to pass the conformance test [22, 23].
As the Web Accessibility Initiative (WAI) phrases it: “[…] Web accessibility eval-
uation tools can not determine the accessibility of Web sites, they can only assist in
doing so.” [21]. It is relatively easy for an automatic tool to determine if an “alt” attribute
is present for an image, but hard to tell if the alternative text conveys any meaning to a
Conducting Acceptance Tests for Elderly People on the Web 327
specific user. But nevertheless, technical accessibility is a requirement, since the

occurrence of a barrier is also connected with defects in the web application [8].
Semantical Accessibility. Characterizes that the content must be understandable and
usable for the user. A web application could be perfectly accessible according to
guideline conformance, but can still be inaccessible to some users. If one doesn’t
understand how to proceed at a certain stage of “purchasing a product” in an online
shop, it is a barrier [8]. Strategies to overcome those issues are widely known in the
school of usability design. On prominent example is the concept of personas, as
introduced by Cooper in [24]. Personas are illustrations of hypothetical users. They are
composed by an aggregation of stories, requirements, needs, goals and preferences of
the product’s end users. Personas are used to clarify features or the workflow of an
application by rising questions like: “Would Anna know what to do at this point of the
purchasing process?” or “Is it clear for Anna what to enter in this web form?” (Where
Anna is the name of a persona) [25].
According to [19] elderlies often have anxieties in using systems, which they are
not familiar with. Keeping the interaction paradigm consistent across application of the
same kind empowers users to apply their learned interaction patterns they are familiar
with. It is crucial to know who the products audience is, what their motivations, skills,
goals, and preferences are, in order to meet the semantic accessibility.
The remainder of this paper is structured as follows: Sect. 2 introduces the general
concept of our approach. Section 3 provides an introduction to the preference set of the
Global Public Inclusive Infrastructure (GPII) [31] and how we envision deriving
accessibility requirements. Section 4 provides a discussion on our work and an outlook
on the current status and the next steps.
2 Concept of Persona-Based Accessibility Testing
Testing the accessibility is of special importance for Rich Internet Applications (RIAs)
[26]. Typically those web applications have a complex behavior and generate large
parts of their user interface components at runtime. Therefore, the accessibility of a
RIA cannot be fully clarified by looking at the HTML code only, since lots of user
interface elements are generated at runtime due to user interaction. This demands the
conduction of acceptance tests [17], and involves testing the application as rendered in
the browser, with dynamic code (e.g., JavaScript) being executed, and the user inter-
acting with the application.
We are proposing an accessibility evaluation method for RIAs, focusing on tech-
nical and semantic accessibility. We understand conducting acceptance tests as testing
a web application in the same way an end user would interact with. Our evaluation
method is semi-automatic, which means that we are testing for technical accessibility,
based on the WCAG 2.0 conformance, but also for semantic accessibility, by pointing
the tester to potential problems derived from the end users’ requirements and prefer-
ences. To control and simulate user interaction in a browser we use Selenium [32],
an open source framework that is capable of simulating user interaction (e.g., inter-
acting with buttons or filling in web forms) in the browser.
328 A. Henka et al.
To provide a user-centered evaluation approach, we adapt the persona concept and

use it as a vehicle to aggregate information about what and how a certain web appli-
cation should be tested [14]. The typical domain of a persona is the actor’s role in a
scenario. This consists of a setting, the initial situation, and a storyline, the plot. The
exact process of how a scenario evolves depends on the actor, their decisions, and
traits. If the actor is exchanged, the scenario can have complete different outcome,
despite the same initial situation and plot [27]. In order to use personas to conduct
accessibility tests, we have to work in their domain.
So, rather than walking a list of technical problems that has been generated by a
conformance-testing tool, the developer evaluates an application’s accessibility based
on the application-specific use cases and user scenarios. We define a user scenario as
an instance of a use case, but with concrete usage data. For each use case of a web
application, a user scenario with concrete usage data can be produced, by describing an
interaction pattern for a dedicated use case. To underline its reusable character, we call
this a Blueprint - since the role of the actor is exchangeable. This Blueprint consists of
real usage data and an interaction pattern.
Each user scenario has an actor, typically represented by a persona. A persona
consists of stories to illustrate the success criteria of accessible guidelines. Therefore,
development teams can empathize with their target audience and use techniques like
the barrier walkthrough to question features and functions.
Personas also provide a machine-readable representation, which consists of a
persona-specific interaction pattern, such as keyboard-only navigation, and a set of
relevant WCAG 2.0 [18] success criteria. The Blueprints and the personas provide the
input for the acceptance tests. They tell the test system what and how to test and which
interaction patterns to use, e.g., “check only for specific success criteria (e.g., WCAG
2.0) that are relevant for a particular preference set (persona), and consider navigation
by keyboard or screen reader”.
These tests are executed in the web browser of the client, as a simulation of how
end users interact with the application. The basic principle of the system is to follow the
navigation pattern, according to the Blueprint, but with the accessibility constraints
imposed by the persona. Thus, the test system can automatically perform end-user
acceptance tests, as introduced in a similar approach [17].
In extension to [14], we now use the GPII preference set [20] as a foundation to
derive the user-specific interaction patterns and accessibility constraints for our
machine-readable personas. Since a user can adjust their settings any time, and for any
application, to fit their current needs, we are able to track the changing accessibility
requirements of age-related disability issues, as discussed in [4]. The concept of this
approach is illustrated in Fig. 1.
2.1 Blueprint Description

We designed a domain-specific language to describe the nature of a Blueprint, based on
the work of Watanabe, Fortes and Dias [17]. They introduce a language to describe the
interaction of people with disabilities in acceptance tests. They use explicit statements
to express a specific navigation pattern, e.g.; use tab navigation. In contrast to
Fig. 1. Overview of the concept and the accessibility evaluation process
Watanabe, Fortes and Dias, a Blueprint doesn’t include any specific interaction or
navigation instructions. It defines only the interaction intention with certain elements,
but not how this interaction, e.g., by mouse or keyboard, is performed, since the
interaction is specific to a dedicated actor; just like the individual accessibility
requirements. As the name implies, a Blueprint is an interaction draft, including only
the setting and the plot. The outcome, also known as the level of accessibility relating
to an application’s use case, depends on the derived accessibility requirements and
could be different amongst actors. Listing 1 shows an example of a Blueprint
description.
The test system performs live interaction in the web browser. For every step in the
Blueprint, the system performs an accessibility check, which is done automatically for
those cases that can be clearly judged programmatically. For the cases where human
judgment is required, e.g., verification for an image’s alternative text, the system should
hold the execution of the Blueprint and present the potential issues to the human tester.
The tester can directly inspect the issues and decide about its validity. The same
process applies for issues that fall under semantic requirements. By using GPII pref-
erence sets that are specific to an application, we can provide an evaluation method that
is specific for this application, based on the application’s end user requirements.
Since the test runs semi-automatically, the tester is part of the interaction and can
empathize with the accessibility requirements more directly. Ignelzi [28] illustrated it
nicely by using the metaphor of a farm for describing our knowledge and awareness for
a certain problem domain. Everybody lives on their own farm and our knowledge and
experience to a particular problem domain is limited to what we know and experienced
on our own farm. By visiting other people’s farms and seeing the same situation trough
their eyes, our understanding and awareness for a specific problem domain increases.
This implies that if one experiences the interaction, issues, and problems others stumble
upon; one can get a better understanding for accessibility requirements. Changing the
point of view can be an asset for web authors to make accessibility guidelines more
comprehensible [15, 16]. Furthermore, the use of personas is a nice way to organize
such trips to farms of other people [24, 25, 29, 30].
330 A. Henka et al.
Listing 1. Illustration of a Blueprint on basis of a use-case: “product search” in a

fictitious web shop.
Scenario: Product Search

Given The actor navigates to: "www.WebShopExample.com"
When The actor enters "Sneakers" into the text field whose @id
is "productSearchField"
And The actor interacts with a button labeled with "Search"
Then The actor should be on a web page with "Search Result -
Sneakers" in the title
3 The GPII Preferences Set
The GPII [31] is a generic system to transfer user needs and preferences between
devices and contexts. One of the core artifacts within the GPII process flow is the needs
and preference set. Such a set is specific per user and stores preferences and settings for
applications used in the past. When new devices or contexts are encountered, the GPII
tries to reconstruct the way known applications were set up for new, unknown appli-
cations. The following example scenario illustrates this auto-adaptation process.
Auto Adaptation Example Scenario: Martha. Martha has a notebook for surfing the
internet and writing emails. At work, she has a personal computer and writes product
reviews and uses an office suite for writing texts, both at home and at work. She is glad
to have managed to use this application, and does not know much about other software.
When she works with her office suite, she uses the computer mouse in the office and the
touchpad on her notebook at home. For other features, such as text formatting, she uses
the toolbar of the application. At work she received an assignment to write a report,
together with her colleagues. They have agreed to use a new internet-based tool that
allows them to work in parallel on the same text. It also promises to adapt automatically
to the user’s needs and preferences. Yet, the tool is different from the office application
Martha is familiar with and she has never used a similar tool before.
Martha goes to the website and registers for the new tool. Before she can start using
it, she has to fill out a questionnaire that asks a few questions about her preferences for
different applications, such as what software she uses, whether she uses keyboard
shortcuts and, if so, what kind of shortcuts.
In fact, the user interface of the web application looks very similar to her desktop
program. She can start working immediately without learning the new interface. There
are a few functions she does not know; however, the program informs her about the
new functionality and tells her that other users (who have a similar set of preferences)
have rated these functions as very practical. Martha reads the descriptions and decides
that two of the four functions might be useful for her and disables the other two
functions. Internally, the system recognizes the user adaptations and stores them in the
user preference set, so the functions will no longer appear.
Over the time, Martha starts to use other Web applications and is very pleased
about how well the user interfaces adapt to her behavior and needs. In particular,
changes she makes in one application are also reflected in the other applications.
Meanwhile, she wants this functionality for all of her applications.
A GPII preference set stores settings for an application for various contexts. Such a
representation is sufficient for many use cases that cover a wide array of accessibility
adaptations, for example increased font size, zoom factor, screen-reader settings etc. In
the GPII, a context is a set of environmental information, such as lighting conditions,
screen size or available software stacks. The functionalities of a needs and preference
set and their adaptation is illustrated by transferring settings from one application to
another, either in a direct relation manner, e.g., a setting is semantically equal in both
applications, or in a subset or superset relation manner, e.g., if a setting in one
application can be semantically represented by multiple settings of the other applica-
tion. These relations are sufficient to represent many relations, but there are large
families of adaptations for which this approach is not sufficient.
One example of an adaptation that cannot be expressed sufficiently is content
adaptation. While a setting can express that the user requires alternative texts for
images, it does not help an application actually to produce an alternative text. Or, if a
setting expresses the user’s desire of having always a search field to look up content,
which is important for the elderly [19], won’t empower a web application to generate a
corresponding form element. This can result in inaccessible applications being unable
to meet the desired preferences, not because they are not programmed to do so, but
because they did not provide the relevant content to perform the adaptation.
3.1 Deriving Accessibility Requirements

Instead of transferring preferences to adapt a specific target application, we derive
accessibility requirements and transfer the user preferences into a format to be used in
accessibility acceptance tests.
Preferences, like language settings or a specific contrast ratio that can be mapped to
WCAG criteria, are transferred in a direct relation manner and checked by guideline
conformance. Generally, one can distinguish between different types of success criteria:
Success criteria that can be evaluated programmatically, success criteria that can be
detected automatically but need human verification, and success criteria that cannot be
detected automatically and so need human verification in any case. Therefore, the test
system should point the tester to issues where human verification is required. Since we
are conducting live interaction, we are able to expand the space of success criteria that
can be tested automatically. An example is the navigation pattern of a user, e.g.,
navigation by keyboard. We can hereby test the conformance to WCAG guideline 2.1
Keyboard Accessible.
Usually semantic requirements come in the form of textual descriptions [19] or
wrapped in stories, if personas are used [24, 25]; therefore, we propose to use textual
requirement-statements, which are presented to the tester during the Blueprint execu-
tion. An example: If the use-case “searching for a product” is evaluated for its
accessibility, the system would show a semantic requirement, e.g., “Make sure that the
search button is labeled with “Search” or an equivalent text so that it is clear where to
click”, before the Blueprint step, where the actor should interact with a button to initiate
the search, is executed; cf. Listing 1.
332 A. Henka et al.
By approving the statement, the tester confirms that the corresponding semantic
requirement is met. Single properties, or combination of properties, in a preference set,
can be used to aggregate requirements for semantic accessibility. The study in [19] lists
semantic requirements for elderly people, which can serve as a foundation for textual
requirement statements. Another approach would be that textual requirement state-
ments are stored in the user preference sets; therefore, a user can define their prefer-
ences directly.
Listing 2. Illustration of the envisioned format in JSON syntax, derived from the GPII
preference set and used to create the accessibility requirements of an actor. The text
content is partially from [19]. This showcase refers to a use case that is characterized by
the Blueprint: “product-search”, in Listing 1.
"product-search":{•
"technical":{•
"WCAG":{•
"automatic":[•
"Guideline3_1.3_1_1",
"Guideline4_1.4_1_2"•]•,
"manual":[•"Guideline1_2.1_2_3"]•
}
"selenium":{"navigation_pattern" : "keyboard"}
},
"semantic":{
"text_field":["Display search as an open, visible
field on all pages (I found it usually in
the upper right corner) with a Search button
to its right"],
"button":["Make sure to label the search button with
„Search“ or an equivalent text so that it
is clear where to click"
,"Make sure to describe in which format the
search query should be entered"]
}
}•
3.2 Benefits of Storing Accessibility Requirements as GPII Preferences

Part of the GPII process of transferring settings from one context to another is clus-
tering. The GPII exploits similarity between users [33]. Similarity is derived from
clustering. This clustering can be utilized to allow automatically derive matching
accessibility requirements for users. For example: Given, we have 100 user preference
sets, which were found to be similar, and some of them have associated accessibility
requirements, similar to listing 2. Depending on the similarity-distance between those
preference sets, the accessibility requirements can be propagated and even automati-
cally altered to match the respective users.
Sometimes people can be uncertain what settings they need to accommodate their
needs or from which setting or assistive technology they could also benefit from.
Therefore, the GPII can make suggestions based on clustering and the preference set
similarity, as illustrated in the GPII adaptation scenario in Chap. 3. Hereby, we’re able to
derive accessibility requirements that are essential for users sharing similar preferences,
but which does an individual user not necessarily considered as a requirement in first
place; yet, users can benefit from the compliance with these additional requirements.
As expressed by its name, a preference set reflects the needs and desires of a user.
Besides requirements for technical accessibility, preferences can also include semantic
requirements. By using the information derived from the preference set, we’re able to
work with personal accessibility requirements and won’t relay on accessibility guide-
lines only; therefore, addressing the need for a more user centered and personalized
accessibility evaluation [8–11].
The preference set is refined every time the user states new preferences or alters
exiting ones. Hereby, the GPII learns more about a particular user and can provide
better adaptations. Due to this process, preference sets are always up-to-date, which
enables a constant tracking of accessibility requirements. This is of special interest for
elderlies where accessibility demands can change over time and new or addition dis-
abilities can accrue [4, 7].
4 Discussion and Next Steps
When using the GPII to transfer settings from one application to another, mismatches
can also occur, e.g., if the target application doesn’t provide suitable settings for
properties in the preference set or applications can have settings that share some of their
semantics, but also involve side effects or constraints that are not present in both
applications. When transferring preferences into accessibility requirements we will
most likely run into similar mismatches.
As a potential improvement, we propose to decouple the users’ needs and prefer-
ence sets from its usage fashion in the GPII and define a preference set format, which
contains dedicated accessibility preferences and usability needs. Therefore, minimizing
the potential mismatches when transferring preference sets into use-case specific
accessibility requirements. The GPII preference set allows storing preferences for
specific applications, so called application-specific preferences. In a first attempt, we
can adopt this concept by storing use-case specific preferences for accessibility tests, as
application-specific. Hereby, we would still be able to transfer preferences into
accessibility requirements, but would define a distinct preference set format within the
structure of GPII.
As described in [24, 25], personas are vehicles for shipping requirements, preferences
and goals of a product’s target audience. On this account they are highly specific to a
certain product or product domain and cannot be properly used for other products. Since
we use machine-readable personas to express accessibly requirements for defined uses
cases of a product, they cannot be reused for accessibility tests in different products as
well, especially if different requirements apply. The more specific the requirements for
certain use cases are, the more precise we can state the accessibility of those use cases and
the application. This restricts the application scope of our system, to test the use cases of
one defined application with the preferences of the target audience.
In the usage scenario, our approach is integrated in the development process, where
a web author provides Blueprints and user preferences (of the target audience) are used
334 A. Henka et al.
to generate machine-readable personas; however, we don’t advocate substituting the

usage of personas or accessibility evaluation techniques. We see our approach as an
addition to established workflows and as a support for a more user centered accessi-
bility evaluation.
This project is work in progress. So far, we have developed a prototype, which is
capable of conducting accessibility evaluations on a technical level. Currently, we are
enhancing our prototype to provide guidance for semantic accessibility. In a next step,
we will use this prototype to conduct user tests, with web authors and students from the
field of computer science, to validate the workflow and the concept for its usability
among web authors and analyze the effectiveness of our approach in comparison with
other accessibility evaluation methods.
Acknowledgments. Part of the research leading to these results has been researched within the
Cloud4all project. Cloud4all is an R&D project that receives funding from the European
Commission under the Seventh Framework Programme (FP7/2007-2013) under grant agreement
n° 289016. This publication reflects only the authors’ views and the European Union is not liable
for any use that may be made of the information contained herein.
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Older Adults’ Usage of Web Pages:
Investigating Effects of Information Structure
on Performance
Jincheng Huang(&), Jia Zhou, and Huilin Wang
Department of Industrial Engineering, Chongqing University,

Chongqing 40044, China
[email protected], {zhoujia07,azerrman}@gmail.com
Abstract. This study focuses on older adults’ usage of web pages. An exper-
iment consisted of three information structures (the net structure, the tree
structure, and the linear structure) was conducted to investigate effects of
information structure (IS) on older adult’s performance. Three findings were
found. First, the number of clicks was the fewest in the net-structure web page
among three web pages. Older participants spent less time to complete the tasks
in the linear-structure web page than the other two web pages. The number of
clicks and the accuracy of participants answered the questions in the
tree-structure web page were the highest among three web pages. Second, older
participants’ performance of card sorting was positively correlated with the task
completion time. And there was a positive correlation between spatial ability
and the performance of older participants. Third, older participants showed the
highest preference of the linear structure among three information structures.
They always lost task targets in the tree-structure web page, especially when
they needed to transfer from one branch of the tree structure to another branch.
This indicated that a simple IS was better used and understood by older par-
ticipants than a complicated one.
Keywords: Information structure Older adults Web pages Navigation
1 Introduction
Older adults have some disadvantages in effectively utilizing the Internet as an infor-
mation resource (e.g., shopping or reading news on the Internet) compared with young
adults. For instance, older adults easily get lost in the deep hierarchical menus of
mobile phones because of the declined spatial ability [1]. And other information
structures such as the net structure and the linear structure are wildly used in the design
of web pages or mobile devices. Previous studies have shown that users would have
problems navigating the information in the website when the information structure did
not match users’ mental model [2]. To know which information structure(s) will be
better used and understood by older adults is important for practitioners.
This study aims to investigate how information structure influences older adults’
navigation performance on web pages. Specifically, older participants would use three

DOI: 10.1007/978-3-319-20892-3_33
338 J. Huang et al.
web pages built with the net structure, the tree structure, and the linear structure in an
experiment. Results of this study help older adults have good user experience of
technology products.
2 Literature Review
It is important to display the content according to how people access information when
organizing the content of a website [3]. Since a meaningful information structure will
promote efficient navigation, to ensure that information is organized in a way that is
meaningful to its target users is essential when designing websites [4].
Compared with younger adults, it was difficult for older adults to find a function in
a broad menu. Furthermore, it was also not a simple job for them to remember the
interaction steps in a deep menu. Therefore, a mobile phone’ menu which had fewer
functions and was shallower than one which had broader functions and was deeper
would be better used by older adults [5]. Zaphiris et al. (2003) had also found that
shallow hierarchies were preferred to deep hierarchies by both young adults and older
adults in a hierarchical online information system [6]. However, detailed information
about the relationship of different branches in the tree structure is little known.
Previous studies indicated two solutions to reduce older adults’ menu disorienta-
tion. One solution was to provide information about the position in the hierarchical
menu. The “tree” aid with the parent categories and the “category” aid were tested. The
results of the test showed that this solution was helpful for older adults [7]. The other
solution was to use a circular menu in a smart phone for older adults’ healthcare
support. Older participants who evaluated the usability evaluation could rotate the
wheel at the side of a smart phone to select menu items, and this circular menu was
better used by them [8].
3 Methodology
An experiment was conducted to investigate which information structure(s) would be

better used and understood by older adults. The net-structure web page, the
tree-structure web page, and the linear-structure web page about Chinese history which
were not widely known by older adults (e.g., those great poets in Tang dynasty such as
Li Bai, Du Fu, and Bai Juyi were commonly known while Lu lun and Gu kuan were
not) were utilized in this experiment. Older participants’ performance among three web
pages was observed.
3.1 Participants
A total of 12 older adults from Yuzui Citizen School in Jiangbei District of Chongqing,
China were recruited as participants. Older adults who were literate and aged above 60
were eligible for this study. The age of the participants ranged from 60 to 75 years old
(Mean = 64.3, SD = 5.46). In total, there were five male participants and seven female
participants.
Older Adults’ Usage of Web Pages: Investigating Effects 339
3.2 Task
In this experiment, three web pages about ancient invention, ancient books, and ancient
historical character of different Chinese dynasties were presented to participants. There
were eight tasks for each information structure. Each participant was required to read
three web pages and complete the tasks separately. In each web page, participants
firstly watched the task specification, secondly they found the target according to the
task specification by touching the hyperlink in the web page, and finally they answered
two questions according to the content which was shown in the web page (see Fig. 1).
Here is the explanation of the task specification provided by Morae Recorder which
is shown in Fig. 1.
Fig. 1. Interface of the net-structure web page used in this experiment
Please find the message of Daitian Method in this web page. Click the “Start
Task” button to begin this task. Click the “End Task” button to finish this task and
answer the question.
*Only the Chinese characters were displayed in this experiment.
3.3 Dependent Variables

The dependent variable was participants’ performance of using three web pages. It was
measured through task completion time, the number of clicks, and task effectiveness.
Both of the task completion time and the number of clicks were recorded by Morae
Recorder. The number of errors of participants’ answer was analyzed by Morae
Manger.
340 J. Huang et al.
3.4 Independent Variables

The independent variables were three information structures: the net structure, the tree
structure, and the linear structure. Besides, demographic variables including age, spatial
ability and computer experience were considered as covariates in this experiment. Age
and computer experience of participants were measured through a questionnaire.
Participants’ spatial ability was tested through the spatial location-memory span tester.
Under the display of the tester, red buttons would randomly appear, and participants
were required to press the buttons in the sequence as they appeared. After that, the
number of red buttons increased and participants would repeat this process. Partici-
pants’ spatial ability was measured through the maximum number of digits, the highest
scores, and the number of errors (see Fig. 2).
Fig. 2. Instruction of spatial location-memory span tester
The number of nodes for the net structure, the tree structure, and the linear structure
is 40, 37, and 24 accordingly. Nodes of the vertical navigation bar and the horizontal
navigation bar are connected by hyperlink. The depth of the tree structure is four, and
the breadth of the tree structure is three. Figure 3 has shown one of the groups of the net
structure, one of the branches of the tree structure and part of the linear structure.
Fig. 3. The information structure of three web pages

3.5 Experimental Design

Within-subjects design was used. Each participant read three web pages built with the
net structure, the tree structure, and the linear structure (see Fig. 4) and completed the
tasks. In order to prevent the “learning effect”, the order of presentation of three web
pages was counterbalanced.
Fig. 4. Three web pages built with concept model
3.6 Equipment and Procedures

A notebook computer (ThinkPad S1 Yoga) with Microsoft’s Windows 8.1 operating
system and Google Chrome (version 37.0.2062.120m) Browser was used for the
experiment. Since novice older adults have difficulty in using a mouse, a computer with
a touch screen is a better choice than a mouse. The experiment was conducted in a
separate room in the Yuzui Citizen School in Jiangbei District of Chongqing, China.
Each participant was encouraged to complete the experiment individually. They could
ask for help but it would be recorded.
The experiment took each participant about 60 min. Firstly, each participant began
the experiment by filling out a consent form and a general questionnaire about his/her
demographic information and experience with computers and mobile phones. Sec-
ondly, a spatial ability test was conducted by using a spatial location–memory span
tester. Thirdly, a brief introduction and practice about the experiment was given to each
participant. Fourthly, participants completed tasks of each web page and then went on
with card sorting. The cards were the titles of each node in the information structure.
Morae Recorder (version 3.3.3) was used to present the task specification for partici-
pants. At the end, the experimenter conducted a five-minute exploratory interview with
the participants to know their thoughts and feelings about using three web pages. The
question in the interview included “In three web pages, which was the most com-
fortable one and the worst one for you? And why?”.
342 J. Huang et al.
4 Results and Discussion

4.1 Descriptive Statistics
There were a total of 12 participants in this experiment (five males, seven females).
83.3 % of the participants earned 300–1200 RMB per month; 50 % of them had more
than two-year experience of using smart phones; 34 % of the participants had more
than two-year computer experience.
4.2 Effect of Information Structure

The influences of information structure on older participants’ performance of using
three web pages were tested. Repeated ANOVA was used to analyze data.
As to average completion time, the standard deviations were very large, making the
interpretation of the results different. Table 1 indicated that there were significant
differences among three information structures in task 2 and task 3. One possible
reason was that participants accidently touched the end button immediately after the
task began.
Table 1. The influences of information structure on task completion time

Task Task completion time (s) df F p
Net structure Tree Linear
structure structure
Mean SD Mean SD Mean SD
1 59.92 29.70 65.70 37.00 69.50 58.75 2 1.777 0.193
2 52.53 17.44 45.74 24.33 28.54 20.79 2 3.666 0.046*
3 64.12 30.93 55.99 22.73 29.89 21.51 2 4.528 0.026*
4 46.00 13.96 48.40 26.10 38.17 23.50 2 0.628 0.545
5 42.06 19.57 31.75 23.78 30.44 17.54 2 1.753 0.199
6 38.50 22.30 26.63 24.87 34.03 29.61 2 0.452 0.643
7 43.56 17.89 34.54 22.79 29.20 16.28 2 2.296 0.127
8 38.47 24.66 27.71 17.55 26.70 15.55 2 1.726 0.203
Average 48.14 22.06 42.06 24.89 35.81 25.44 2 2.322 0.114
Note: *Significant at 0.05 level
Table 2 indicated that information structure had significant influences on the

number of clicks. Older participants clicked fewer to complete the tasks in the net
structure than the tree structure and the linear structure, and this may because they
could use the horizontal bar in the net structure to have an overview of the content in
the web page. And the number of clicks to complete the tasks was the highest in the
tree-structure web page among three web pages. One possible reason was that par-
ticipants easily got lost when they found the target in the tree-structure web page.
Table 2. The influences of information structure on the number of clicks

Task The number of clicks df F p
Net Tree Linear
structure structure structure
Mean SD Mean SD Mean SD
1 6.83 3.81 9.67 6.86 12.75 12.82 2 1.777 0.193
2 6.70 3.23 6.60 5.40 5.20 3.65 2 0.330 0.721
3 7.20 4.80 11.20 5.07 6.40 6.90 2 1.598 0.230
4 4.90 2.38 12.20 10.86 11.50 10.66 2 2.793 0.087
5 7.27 6.52 9.55 7.42 5.18 2.63 2 2.055 0.154
6 4.90 2.72 8.50 6.29 6.50 3.97 2 1.211 0.321
7 5.82 2.31 10.00 7.52 7.00 3.71 2 3.629 0.045*
8 4.34 2.34 6.18 2.23 7.45 4.87 2 11.723 0.003*
Average 5.99 3.51 9.23 6.40 7.75 6.15 2 12.143 0.0008*
Note: *Significant at 0.05 level
As to the net-structure web page, older participants spent more time to complete
tasks on the net structure than the tree structure and the linear structure. Meanwhile, it
was easier for participants to find targets in the net-structure web page than the other
two web pages. The number of clicks of the net structure was fewer than the tree
structure and the linear structure.
As to the tree-structure web page, the number of clicks of the tree structure was
higher than the net structure and the linear structure. Only one older participant pre-
ferred the tree structure to the net structure and the linear structure. Other older par-
ticipants easily got lost in the tree structure. They stayed in a page for a long time or
staying in a cycle of going and returning back of one page in the tree structure.
Particularly it was difficult for them to cross one branch to another branch in the tree
structure.
As to the linear-structure web page, older participants spent less time to complete
the tasks than the other two web pages. 58 % of the older participants preferred the
linear-structure web page to the net-structure web page and the tree-structure web page.
As to the task effectiveness, older participants completed the tasks with a higher
accuracy in the linear structure than the net structure and the tree structure. The
accuracy of participants answered the questions for the net structure, the tree structure,
and the linear structure was 63 %, 67 %, and 87 % accordingly. And the total number
of errors of participants’ answer was 35 in the net structure (Mean = 2.92, SD = 1.505),
31 in the tree structure (Mean = 2.58, SD = 1.564), and 12 in the linear structure
(Mean = 1.00, SD = 1.279). The results of repeated ANOVA indicated that information
structure had significant influences on task effectiveness (F = 7.654, df = 2, p = 0.003).
344 J. Huang et al.
4.3 Effect of Card Sorting

The total number of errors of participants’ card sorting was 21 in the net structure
(Mean = 1.75, SD = 1.423), 38 in the tree structure (Mean = 3.16, SD = 0.935), and 10
in the linear structure (Mean = 1.91, SD = 1.514).
As the results of correlation analysis between performance and the card sorting
indicated, the performance of card sorting was positively correlated with the task
completion time. However, it was not correlated with the number of clicks. The cor-
relation coefficient between card sorting and performance are shown in Table 3.
Table 3. Correlation coefficient between performance and card sorting’s result

Task completion time The number of clicks
Correlation coefficient 0.453* 0.302
p 0.006 0.074
Note: *Correlation is significant at the 0.05 level
4.4 Effect of Covariates

Three demographic variables (spatial ability, computer experience, age) were considered
as covariates. The correlation between the demographic variables and older participants’
performance are shown in Table 4. As to the spatial ability of participants, the maximum
number of digits was ranged from five to seven (Mean = 6.16, SD = 0.572). The highest
scores were ranged from 3.66 to 5.66 (Mean = 4.67, SD = 0.691). The number of errors of
participants was ranged from three to nine (Mean = 6.00, SD = 1.852).
Table 4. Correlation coefficient between performance and demographic variables

Task completion time The number of clicks
Age Computer Spatial Age Computer Spatial
experience ability experience ability
Correlation 0.481 −0.162 −0.758* 0.419 0.102 −0.585*
Coefficient
p 0.113 0.614 0.004 0.175 0.753 0.046
Note: *Correlation is significant at the 0.05 level
The results of this test showed that older participants would make more mistakes
when the maximum number of digits was more than six. The number of errors of
spatial ability was selected as the variable for the correlation between the performance
and spatial ability. And participants who completed the spatial ability test with fewer
errors may complete the tasks faster.
As to computer experience, four participants had more than two-year computer
experience while eight participants had not used computer before. Older participants
who had experience of using computer spent less time to complete the tasks than those
who had not the experience.
4.5 Discussion
First, older participants completed tasks efficiently when finding targets in the
net-structure web page. They clicked the web built with the net structure less frequently
than the tree structure and the linear structure. However, older participants felt lost in
the net structure. This was because the relationship between the vertical navigation bar
and horizontal navigation bar in the net structure (see Fig. 4) was difficult for them to
understand. Specifically, older participants could easily find the target with horizontal
navigation bar while could not catch the detailed information of this target by the
vertical navigation bar in the net structure. Therefore, they spent more time to complete
the tasks in the net-structure web page than the tree-structure web page and the
linear-structure web page.
Second, older participants felt confused at the second or third level of the tree
structure in this experiment. They stayed in a page for a long time or staying in a cycle
of going and returning back of one page in the tree structure. And it was difficult for
older participants to transfer from one branch to another branch in the tree structure.
The experiment’s results indicated that older participants could easily turn to the
next page, but it was not a simple task for them to turn to the front page in the tree
structure. Therefore, the design like the home button used in a smart phone may help
older adults to understand technology products well.
Third, the linear structure was the easiest one to use for older participants among
three information structures. Therefore, a design like a horizontal navigation bar
continuing with a linear structure (e.g., the tree structure with eight items on each of
two levels) may be accepted by older adults.
Fourth, older participants tended to focus on the content of the web page while
always ignore the relationship between each page in this experiment. Therefore, a hint
about the relationship between each page (level) in the web page may be better used by
older adults.
5 Conclusion
This study investigated older adults’ performance of using three web pages built with
three information structures. To help older adults have good user experience of tech-
nology products, three web pages built with three information structures were tested.
Based on the results, three main findings were derived:
First, the number of clicks was the fewest in the net-structure web page among
three web pages. Meanwhile, older participants spent less time to complete the tasks in
the linear-structure web page than the other two web pages. The number of clicks and
the accuracy of older participants answered the questions were the highest in the
tree-structure web page among three web pages.
Second, older participants’ performance of card sorting was positively correlated
with the task completion time. In addition, there was a positive correlation between
spatial ability and the performance of older participants’ usage of web pages.
Third, most of the older participants preferred the linear structure to the net
structure and the tree structure. Meanwhile, most of the participants thought the tree
346 J. Huang et al.
structure was difficult to use, and they always lost task targets in the tree-structure web
page, especially when they needed to transfer from one branch of the tree structure to
another branch.
Acknowledgment. This work was supported with funding from a National Science Foundation
China grant 71401018 and a Chongqing Scientific and Technological Project cstc2012gg-
yyjs70009.
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Perceived Barriers for Older Adults’ Shopping
Channel Selection Toward Online Shopping
Comparisons Between Different Business Models
Jiunn-Woei Lian(&)
Department of Information Management,

National Taichung University of Science and Technology, Taichung, Taiwan
[email protected]
Abstract. The aim of this study is to understand perceived barriers for older
adults to select novel shopping channel. Questionnaire survey was employed.
Innovation resistance theory is served as the theoretical base for this study. Five
innovativeness acceptance barriers (usage barrier, value barrier, risk barrier,
traditional barrier, and image barrier) and three business models (online shop-
ping oriented vs. TV shopping oriented vs. hybrid) were investigated. 108 valid
respondents who are older than 50 years old and have online shopping expe-
rience participated in this study. The major results including: (1) The order of
the barriers for older adults to adopt novel shopping business models is risk
barrier, traditional barrier, image barrier, usage barrier, and value barrier.
(2) There exist significant (p < 0.01) different in traditional barrier and image
barrier among different business models. (3) Value barrier, risk barrier, and
traditional barrier have significant (p < 0.05) impact on novel shopping business
models acceptance.
Keywords: Older adults Shopping channel Perceived barriers Business

model
1 Introduction
Shopping behavior is an interesting topic in the marketing field. With the coming of EC
(electronic commerce), issues related to shopping channel selection became more and
more important, especially for online shopping. Scholars from difference fields paid
more and more attention to the related issue. For example, many related researches
from IS/IT perspective have been appear in EC related journal. International Journal of
Electronic Commerce is a good example. However, most of the previous studies have
been focused on younger customers (such as students), they serve younger as major
potential market for online commerce. Indeed, with the coming of aging society, the
role of older adults toward online commerce is becoming more and more critical. The
percentage of older adults in Asia countries’ population structure is listed in Table 1
[1]. From Table 1, we can see that older adult will becoming more and more important
for consuming market. However, few study have been focused on the related topic.
Therefore, this paper is focused on the barriers for the older adults’ shopping channel
DOI: 10.1007/978-3-319-20892-3_34
348 J.-W. Lian
selection. Additionally, the difference between different business models (online

shopping oriented vs. TV shopping oriented vs. hybrid) have also been investigated.
The aim of this study is to understand perceived barriers for older adults to select novel
shopping channel.
In addition to traditional in-store shopping, nowadays consumers always have other
three shop channels in general. The first is pure online shopping which search, order, and
Table 1. Percentage of older adult in Asia countries

2010 2015 2020 2025
Taiwan 10.9 12.5 15.7 19.4
Japan 22.8 26.6 29.2 30.7
China 8.6 10.1 12.4 14.3
Hong Kong 13.1 15.3 18.5 22.9
Korea 11.1 13.0 15.6 19.7
Singapore 7.2 8.9 10.9 13.2
Malaysia 4.8 5.6 6.9 8.5
Indonesia 6.2 6.6 7.8 9.4
Philippines 4.2 4.6 5.4 6.2
Thailand 8.5 9.9 11.8 14.6
Vietnam 5.5 5.8 6.9 8.9
India 5.3 6.0 6.7 7.7
pay are finishing online. The other one is buying through TV shopping channel, from TV
platform consumer can understand the goods information and buying through telephone.
The third one is that business (seller) who have bother online and TV shopping channel for
consumers. This is defined as “hybrid” business model in present study.
The rest of the paper is organized as follows. Section 2 reviews related studies on
older adults’ shopping channel acceptance and innovation resistance theory. Section 3
introduces the research method and design. Section 4 describes the data analysis
results. Section 5 is the discussions of the data analysis results. Finally, Sect. 6 presents
our conclusions.
2 Literature Review
2.1 Related Studies

Little previous studies have paid attention to the issues which related to older adults,
online shopping and perceived barrier. Focused on older adults’ buying behaviors, Lim
and Kim [5] indicated that in the context of TV shopping loneliness, parasocial
interaction, and convenience are critical factors to understand older adults’ satisfaction
with TV shopping. Lin found that the TV and online shopping values will affect users’
shopping channel selection [6]. In the study of Lian and Yen [4], based on UTAUT
(Unified Theory of Acceptance and Use of Technology) and innovation resistance
theory, they found that the major motivated factors affecting older adults toward online
Perceived Barriers for Older Adults’ Shopping Channel Selection Toward 349
shopping are performance expectation and social influence which is the same with
younger. On the other hand, the major barriers include value, risk, and tradition which
is different from younger. Therefore, older adults have their own characteristics toward
shopping channel selection.
2.2 Innovation Resistance Theory

Innovation resistance theory was proposed by Ram in 1987 [7] to understand why
innovation is resisted by user. It has been applied in various research issues, including
online shopping and IT adoption [3]. Besides, Ram and Sheth [8] also indicated that
five critical barriers which belonging two categories will against users to adopt an
innovation. The two categories are functional and psychological. The five barriers are
usage barrier, value barrier, risk barrier, image barrier, and tradition barrier. The front
three barriers are belonging to functional barrier; the last two barriers are belonging to
psychological. Above five barriers are employed in the present study to understand the
barriers for older adults buying online.
3 Methodology
Survey research method was employed in this study. Older adults who older than 50
years old and taking courses in “Evergreen University” in Taiwan participated in this
study. Six variables are included in this study including: usage barrier, value barrier,
risk barrier, traditional barrier, image barrier, and use intention. The measurement items
have been adapted from previous literatures to insure their reliability and validity.
Besides, items which related to shopping experience have been designed to understand
their previous shopping experience. Famous and general online shopping and TV
shopping businesses or platforms have been listed on the questionnaire to be selected.
Additionally, questionnaire has been revised by researchers and practical experts.
Questionnaires were collected during class. Finally, 108 valid respondents who have
online or TV shopping experience were included in our analysis.
4 Data Analysis
Demographic data is illustrated in Table 2. More female than male and the major age
level is between 56–65 years old. Besides, in Table 3 we can find that 54 % respon-
dents only have online shopping experiences, 28 % only have TV shopping experi-
ences. Finally, 20 % have both of the shopping experiences (hybrid).
Regarding the validity and reliability testing. Confirmation factor analysis and
Cronbach’s alpha were employed in this study. The results indicated that the data have
acceptable validity and reliability (the alpha value is larger than 0.7) [2] except tradition
barrier, but it still in accept level (>0.5) (Table 4). Following are data analysis results
for the research questions.
350 J.-W. Lian
Table 2. Demographic
Number Percentage
Gender Male 46 43 %
Female 62 57 %
Total 108 100 %
Age 51–55 16 15 %
56–60 37 34 %
61–65 24 22 %
66–70 18 17 %
71–75 10 9%
Over 75 3 3%
Total 108 100 %
Table 3. Online or TV shopping experiences

Shopping channel Number Percentage
Online oriented 58 54 %
TV shopping oriented 28 26 %
Hybrid 22 20 %
Total 108 100 %
Table 4. Reliability testing

Variables Usage Value Risk Tradition Image Intention
barrier barrier barrier barrier barrier
Cronbach’s 0.90 0.76 0.75 0.56 0.80 0.95
Alpha
4.1 Barriers for Older Adults Across Different Business Models

From Tables 5 and 6, we can see that the order (from high to low) of the five barriers
for older adults buying online is risk barrier, traditional barrier, image barrier, usage
barrier, and value barrier (the value is between 1 to 5, the lower the value is repre-
senting higher barrier). Besides, the orders of the barriers are various across different
business models (Table 6).
4.2 Different Barriers Between Business Models

ANOVA analysis is employed to see the significant barrier difference between business
models. From Table 7, we can see that there exist significant (p < 0.01) different in
traditional barrier and image barrier among different business models. For tradition
Table 5. Barriers for older adults across different business models

Barrier Business model Mean S.D.
Usage barrier (U) Online shopping 3.63 0.63
TV shopping 3.64 0.71
Hybrid 3.68 0.39
Total 3.64 0.61
Value barrier (V) Online shopping 3.77 0.65
Hybrid 3.55 0.62
Total 3.69 0.66
Risk barrier (R) Online shopping 2.05 0.59
Hybrid 2.08 0.66
Total 2.07 0.63
Tradition barrier (T) Online shopping 2.58 0.63
Hybrid 2.89 0.63
Total 2.55 0.64
Image barrier (I) Online shopping 2.79 0.86
Hybrid 3.23 0.84
Total 2.81 0.86
Table 6. Barrier comparison between different business models

Business model The order of adoption barrier (From high to low)
Online shopping R> T>I>U>V
TV shopping R> T>I>V>U
Hybrid R> T>I>V>U
Total R> T>I>U>V
Table 7. Results of ANOVA analysis

F-value p-value Post Hoc testing
Usage barrier 0.06 0.95 N/A
Value barrier 1.07 0.35 N/A
Risk barrier 0.11 0.90 N/A
Tradition barrier 7.29 0.00* TV shopping vs. online shopping
TV shopping vs. hybrid
Image barrier 4.51 0.01* TV shopping vs. hybrid
* p < 0.01
352 J.-W. Lian
barrier the difference were between TV shopping, online shopping and hybrid. How-
ever, the image barrier is between TV shopping and hybrid.
4.3 The Relationships Between the Barriers and Use Intention

Four multiple regressions were proposed to understand the relationships between the
barriers and use intention toward different business models (online shopping, TV
shopping, Hybrid, and total). The independent variables are the five barrier, and the
dependent variable is the intention to adopt online shopping. Overall, the four models
are significant and have acceptable explanatory power for user behavior (the adj-R2 is
between 0.55–0.61) (Table 8). Additionally, from Table 8, we can find that the critical
barrier are various across different business model. Finally, value barrier, risk barrier,
and traditional barrier have significant (p < 0.05) impact for older adults to shop on
these novel shopping channels (all samples). Additionally, the explanatory power
(Adj-R2) is 57 %.
Table 8. Results of regressions analysis

Adj-R2 Critical barrier (p < 0.05)
Online shopping 0.55 Usage barrier, value barrier
TV shopping 0.61 Value barrier
Hybrid 0.59 Value barrier, risk barrier
Total 0.57 Value barrier, risk barrier, traditional barrier
5 Discussions
From the results, we can find that for older adults, the barrier for their acceptance of
shopping channel are various across different business models. The major barriers for
these novel shopping channels are risk barrier and tradition barrier (Table 5). This is
because when people face new innovation, they will have uncertainty therefore their
will have higher risk barrier (the highest risk barrier is online shopping, TV shopping
have lowest risk barrier). Besides, most of people (especially for old adults) will
familiar traditional physical shopping channel, therefore they will have higher tradition
barrier.
Which business models have significant different? From the results of ANOVA
analysis (Table 7), we can find that the major differences are tradition barrier and image
barrier. The results meant that for older adults, psychological barriers have significant
difference between different business models.
Finally, from the results of regression analysis (Table 8), we can find that inno-
vation resistance theory is suitable for understanding older adults’ acceptance of dif-
ference shopping channel (the R2 are acceptable). Additionally, Table 8 indicates that
functional barriers become critical for understand older adults’ acceptance of difference
shopping business model.
6 Conclusions
This study have three major findings which are listing below:
(1) The order (from high to low) of the five barriers for older adults adopting new
shopping novel business models is risk barrier, traditional barrier, image barrier,
usage barrier, and value barrier.
(2) There exist significant (p < 0.01) different in traditional barrier and image barrier
among different business models for older users.
(3) Innovation resistance theory is suitable for understanding older adults’ innovation
acceptance. Besides, value barrier, risk barrier, and traditional barrier have sig-
nificant (p < 0.05) impact on novel shopping business models acceptance. The
explanatory powers (Adj-R2) are between 0.55–0.61.
Regarding the limitations of this study, first of all, this study only focused on the older
adults who take class in Evergreen University. Other general older adults are not
included in our survey. Second, different countries have various shopping environment
if the results from Taiwan can be applied to difference countries need to be investigated
in the future.
Finally, this study provides advanced understandings regarding older adults to shop
online. Findings can served as the references for academic area in conducting advanced
research and practical area in providing better services for older adults to shop online.
Acknowledgements. The author would like to thank the Ministry of Science and Technology of
Republic of China, Taiwan, for financially supporting this research under contract No. NSC
100-2410-H-025-003-.
References
1. United States Census Bureau. http://www.census.gov/
2. Hair, J.F., Black, W.C., Babin, B.J., Anderson, R.E.: Multivariate Data Analysis: A Global
Perspective. Pearson, London (2010)
3. Lian, J.W., Yen, D.C.: To buy or not to buy experience goods online: perspective of inno-
vation adoption barriers. Comput. Hum. Behav. 29(3), 665–672 (2013)
4. Lian, J.W., Yen, D.C.: Online shopping drivers and barriers for older adults: age and gender
differences. Comput. Hum. Behav. 37, 133–143 (2014)
5. Lim, C.M., Kim, Y.K.: Older consumers’ TV home shopping: loneliness, parasocial inter-
action, and perceived convenience. Psychol. Mark. 28(8), 763–780 (2011)
6. Lin, H.H.: Gender differences in the linkage of online patronage behavior with TV-and-online
shopping values. Serv. Bus. 5(4), 295–312 (2011)
7. Ram, S.: A model of innovation resistance. Adv. Consum. Res. 14(1), 208–212 (1987)
8. Ram, S., Sheth, J.N.: Consumer resistance to innovations: the marketing problems and its
solutions. J. Consum. Mark. 6(2), 5–14 (1989)
Processing Speed and Vocabulary are Related
to Older Adults’ Internet Experiences
Jennifer Romano Bergstrom1(&), Erica Olmsted-Hawala2,

and Wendy A. Rogers3
1
Facebook, 100 Hacker Way, Menlo Park, CA 94025, USA
[email protected]
2
Center for Survey Measurement, U.S. Census Bureau, 4600 Silver Hill Road,
Washington, DC 20233, USA
[email protected]
3
School of Psychology, Georgia Institute of Technology, 654 Cherry St.,
Atlanta, GA 30332, USA
[email protected]
Abstract. Some cognitive declines commonly occur with aging; yet they are
seldom taken into account by Website designers and User Experience
(UX) researchers. In this empirical study, we compared younger adults,
middle-age adults, high-functioning older adults, and low-functioning older
adults to examine whether there is a relationship between aspects of cognition
and performance when using a Website. Performance was measured by accuracy
(percent of tasks completed successfully), efficiency (mean time to complete
tasks) and self-rated satisfaction, three commonly used usability metrics. Results
suggest that processing speed and vocabulary may be related to Internet per-
formance. Specifically, older adults with faster processing speed and/or high
vocabulary may perform better than their lower-functioning counterparts. More
importantly, these older adults perform similar to younger adults.
Keywords: Usability Cognition Aging Computers Internet Technology
1 Introduction
The number of older adults who use the Internet is rapidly growing, and older adults
are the fastest growing group of Internet users [1–5]. The Internet has the potential to
help older adults (e.g., as a source of information, education, social support), yet at the
same time, older adults may experience information overload and challenges when
trying to find pertinent information. Some cognitive declines commonly occur with
age, and various aspects of cognition are crucial to successfully navigating Websites.
For example, spatial skills, short-term memory, processing speed, working memory,
J. Romano Bergstrom—This report is released to inform interested parties of research and to

encourage discussion. Any views expressed on the methodological issues are those of the authors
and not necessarily those of Facebook, the U.S. Census Bureau, or GA Tech.
© International Copyright, 2015, U.S. Department of Commerce, U.S. Government

DOI: 10.1007/978-3-319-20892-3_35
Processing Speed and Vocabulary are Related to Older Adults’ Internet Experiences 355
and sustained attention, which are all well known to decline with age [6–11], are
involved in navigating Websites [12]. Website designers often do not take into account
the cognitive limitations of older users. Thus, many older Internet users end up frus-
trated and dissatisfied [1, 13–15]. Additionally, UX researchers often do not take into
account the cognitive capabilities of research participants in general, which may lead to
inaccurate assumptions about the usability of a product [16]. At present, there is little
empirical evidence about the relationship between age-related cognitive differences and
Internet performance.
The purpose of the present study was to examine the relationship between
age-related decline in cognition and Internet performance. Younger, middle-age, and
older adults completed a standard battery of cognitive tasks to assess processing speed
and vocabulary (a backward counting task, the WAIS Digit Symbol Coding task, and
the Shipley Vocabulary test), which represent fluid and crystallized ability, respec-
tively, and have been shown to be predictive of computer use [17]. Participants also
completed a computer and Internet experience questionnaire, five information-finding
tasks on a US Census Bureau Website, and a satisfaction questionnaire. Performance
on the Website was measured by accuracy (percent of tasks completed successfully),
efficiency (mean time to complete tasks) and self-rated satisfaction, three commonly
used usability metrics [18].
We hypothesized that: (1) There would be age-related differences in performance;
(2) There would be a linear age-related difference such that middle-age adults would
not differ in performance compared to younger and older adults; (3) Older adults with
higher cognitive function would perform similar to younger adults, and older adults
with lower cognitive function would perform worse than younger adults and their
higher-functioning counterparts; (4) Older adults with lower cognitive function would
report lower satisfaction with the Website.
2 Method
2.1 Participants
Twenty-one younger adults (6 males, 15 females), 19 middle-age adults (9 males,
10 females) and 21 older adults (9 males, 12 females) participated in the study. Par-
ticipants were residents of the metropolitan Washington DC area and were recruited via
advertisements in local newspapers or through a database that is maintained by the US
Census Bureau’s Human Factors and Usability Research Group. Participants were
given a $40 honorarium. They completed a questionnaire about their computer use and
Internet experience and completed tasks that measured processing speed and vocabu-
lary. All participants reported being experienced with computers and the Internet but
unfamiliar with the Website used in this study. There was no age-related difference in
reported difficulty in using the Internet, but older adults reported greater difficulty in
learning to use new Websites, compared to younger and middle-age adults. See Table 1
for participants’ self-reported demographics and cognition scores.
356 J. Romano Bergstrom et al.
Table 1. Mean (and range) demographics and cognition scores by age group
Age group Significance

Younger Middle-age Older
N 21 19 21
Gender 15 F / 6 M 10 F / 9 M 12 F / 9 M
Age 23 (18–28) 46 (40–51) 68 (65–76)
15 < BA/BS 11 < BA/BS 6 < BA/BS
3 BA/BS 8 BA/BS 4 BA/BS
Education 3 > BA/BS 0 > BA/BS 11 > BA/BS
Difficulty in learning F(2,53) = 6.08,
1.5 (1–3) 1.4 (1–3) 2.3 (1–5)
to use new Websitesa p < .01
Difficulty in using F(2,53) = 2.93,
1.1 (1–2) 1.2 (1–3) 1.4 (1–3)
the Interneta p = .06
Backward counting F(2,58) = 9.39,
51 (34–75) 57 (30–81) 66 (43–84)
(Processing speed) p < .001
Digit Symbol Coding F(2,55) = 10.86,
79 (48–116) 73 (48–109) 55 (24–91)
(Processing speed)b p = .0001
Vocabulary F(2,58) = 0.86,
31 (22–38) 30 (15– 40) 32 (22–40)
(Verbal ability)c p = .43
a
Scale: 1 (Not difficult at all) – 5 (Extremely difficult)
b
WAIS III, Wechsler Adult Intelligence Scale, 3rd Edition
c
Shipley Institute of Living Scale (Shipley, 1986)
2.2 Procedure
Participants came to the Human Factors and Usability Research Group’s laboratory at
the US Census Bureau headquarters to participate in the study. Each participant sat
individually in a 10′ × 12′ room, facing one-way glass and a wall camera.
The test administrator (TA) explained the study, and the participant read and signed
a consent form. Participants completed a backward counting task, the WAIS Digit
Symbol Coding task [19] and the Shipley Vocabulary test [20], each of which are
detailed below. The TA left the room—the participant and the TA sat in separate rooms
during the remainder of the session and communicated via microphones and speakers.
The TA began video recording from the opposite side of the one-way glass.
Participants worked on five pre-determined information-seeking tasks on the
American FaceFinder (AFF)1 Website. AFF is the Census Bureau’s primary data
dissemination Website about the population, housing, and economy of the United
States (see Fig. 1). Participants completed typical tasks for general users of the
1
In 2012, a new American FactFinder (AFF) was released. The present study was conducted on the
earlier AFF site, which is no longer available online and is referred to as the “legacy” version.
Website, and all completed tasks in the order of easiest to hardest to accomplish
(determined by the complexity and number of steps needed to find the information).
The first two tasks we categorized as easy; they required 2 and 3 steps, respectively,
and the final three tasks we categorized as hard; they required 4, 4, and 6 steps,
respectively. (For a list of tasks, see [21]. Participants read each task aloud then used
the Website to locate the information (while working silently), and they stated their
answer aloud when they felt they had found the correct answer. After the participant
completed each task, the TA loaded the main page of the site, and the participant
proceeded with the next task. At the conclusion of the study, participants completed a
final satisfaction questionnaire and answered debriefing questions from the TA.
Fig. 1. AFF Website home page
Most participants attempted to complete all five tasks. After 7 min working on the
task, the TA asked the participant if they felt they were close or far from the answer and
if they wanted to move on. If the participant wanted to move on, the task ended, the TA
loaded the main page, and the participant began the next task. These tasks, as well as
tasks participants gave up on without the TA prompt, were classified as passes, and
when calculating the accuracy, they were scored as 0. Seven percent of the tasks for
younger adults, 18 % of the tasks for middle-age adults and 31 % of the tasks for older
adults were passes.
2.3 Usability Metrics

We assessed accuracy, efficiency, and satisfaction. For our dependent measures,
accuracy was calculated as the percent of users who successfully completed the task,
efficiency was calculated as the time it took participants to complete each successfully
completed task, and satisfaction was calculated as the participants’ ratings for the 11
items on the satisfaction questionnaire (ratings of 1:low – 9:high). We then averaged
the accuracy, efficiency and satisfaction scores across tasks for each participant (for
accuracy and efficiency) and across participants in each age group (for accuracy,
efficiency and satisfaction). We examined the relationship among age, cognition and
Website performance (usability metrics).
2.4 Cognitive Metrics

We assessed processing speed with two tasks: a backward counting task and the Digit
Symbol Coding task [19]. For the backward counting task, participants were given 30 s
to count backward from 100, by ones, as quickly as possible. The score is the number
that participants get to (i.e., lower number = higher score). For the Digit Symbol
Coding task, participants were given a sheet of paper with seven lines of 20
number-box combinations (the first seven were practice trials). At the top of the paper,
there was a key in which the numbers 1–9 were paired with a unique abstract symbol.
Participants were required to fill in the boxes with the corresponding symbols, in order,
as fast as they can, for two minutes. The score is the total number of correctly filled-in
boxes.
We assessed verbal ability (i.e., vocabulary) with the Shipley’s Institute of Living
Scale [20]. The test was administered on paper and featured 40 items in which the first
word was printed in capital letters, and four words were opposite it. Participants were
instructed to circle the one word (of the four) “that means the same thing, or most
nearly the same thing, as the first word,” and an example was provided. The score is the
sum of correctly identified words.
3 Results
We asked the following research questions:

1. Are there age-related differences in performance (accuracy, efficiency, satisfaction)?
2. Do middle-age adults differ in performance compared to younger and older adults?
3. Do older adults with higher cognitive function perform differently than older adults
with lower cognitive function?
4. Do older adults with higher cognitive function perform similar to younger adults on
the performance metrics?
5. Do older adults with lower cognitive abilities report lower satisfaction than older
adults with higher cognitive abilities?
First we examined accuracy, efficiency and satisfaction across age groups, overall. We
conducted one-way ANOVAs comparing age group and found an age-related differ-
ence for accuracy, F(2,58) = 2.95, p = .06. Planned two-tailed t-tests confirmed no
difference in accuracy between middle-age and older adults (p = 0.28) and no difference
between middle-age and younger adults (p = 0.24). However, there was a significant
difference between younger and older adults (p = 0.01) such that younger adults had
higher accuracy than older adults. For efficiency and satisfaction, there were no
age-related differences (p = 0.36 and p = 0.26, respectively). See Table 2.
Table 2. Mean (and range) performance by age group
Age group Significance

Younger Middle-age Older
62% 51% 41%
Accuracy (20%–100%) (0–100%) (0–93%) F(2,58) = 2.95, p = .06
Efficiency in
seconds 160 169 238
(successes only) (60–325) (59–391) (47–915) F(2,54) = 1.03, p = .36
6.34 6.72 5.87
Satisfaction (3.75–8.45) (3.00–8.64) (2.82–8.70) F(2,58) = 1.38, p = .26
Next we examined each cognitive measure and whether varying levels of cognitive
function impact performance. For each cognitive measure, we split the data into three
parts: upper, middle, and lower thirds. We then compared the “high-functioning” older
adults, the “low-functioning” older adults and the younger adults.
Processing Speed. First we examined the backward counting task. Seven older adults
were classified as high-functioning (HF), with scores between 43 and 60 (x = 53), and
seven were classified as low-functioning (LF), with scores between 72 and 84 (x = 76).
Younger adults’ scores were between 34 and 75 (x = 51). A one-way ANOVA revealed
a significant group difference, F(2,32) = 20.39, p < 0.0001. Tukey HSD post hoc test
revealed a significant difference between HF and LF older adults (p < 0.01), a sig-
nificant difference between LF older adults and younger adults (p < 0.01), and no
significant difference between HF older adults and younger adults.
We compared accuracy by age group and found a significant difference between HF
older adults, LF older adults and younger adults, F(2,32) = 3.58, p < 0.05. However,
Tukey HSD post hoc test revealed no significant difference in accuracy between HF
and LF older adults, between HF older adults (x = 50 %) and younger adults
(x = 62 %), and between LF older adults (x = 32 %) and younger adults. Thus, older
adults with slower processing speed completed fewer tasks successfully compared to
younger adults, and older adults with faster processing speed did not differ from
younger adults. See Table 3.
We next compared efficiency and satisfaction by age group. For efficiency, we
found no significant difference between HF older adults (x = 228 s), LF older adults
(x = 357 s) and younger adults (x = 160 s), F(2,30) = 2.05, p = 0.15. Similarly, for
satisfaction, we found no significant difference between HF older adults (x = 5.79), LF
older adults (x = 5.34) and younger adults (x = 6.34), F(2,32) = 1.34, p = 0.28.
Next we examined the Digit Symbol Coding task. Six older adults were classified as
HF, with scores between 64 and 91 (x = 72), and six were classified as LF, with scores
Table 3. Mean (and range) performance by age group: backward counting
Age Group by Backward Counting Task Significance

Younger HF Older LF Older
62% 50% 32%
Accuracy (20%–100%) (0–93%) (0–60%) F(2,32) = 3.58, p < .05
Efficiency 160 200 309
(60–325) (47–351) (72–915) F(2,30) = 2.05, p = .15
6.34 5.79 5.34
Satisfaction (3.75–8.45) (2.82–8.27) (2.91–7.00) F(2,32) = 1.34, p = .28
between 24 and 38 (x = 34). Younger adults’ (N = 19) scores were between 48 and 116
(x = 79). A one-way ANOVA revealed a significant group difference, F(2,28) = 19.59,
p < 0.0001. Tukey HSD post hoc test revealed no difference between HF older adults
and younger adults. However, there was a significant difference between LF older adults
and younger adults (p < 0.01) and between HF and LF older adults (p < 0.01),
We next compared accuracy by age group and found a significant difference
between HF older adults, LF older adults and younger adults, F(2,30) = 5.08, p = 0.01.
Tukey HSD post hoc test revealed no significant difference in accuracy between HF
older adults and younger adults and between LF older adults and younger adults.
However, we found a significant difference between HF older adults and LF older
adults (p < 0.05). Thus, for this measure, LF older adults completed fewer tasks
successfully than HF older adults. See Table 4.
We next compared efficiency and satisfaction by age group. Consistent with the
backward counting measure, we found no significant difference in efficiency between
HF older adults, LF older adults, and younger adults, F(2,28) = 1.63, p = 0.21. Sim-
ilarly, we found no significant difference in satisfaction between HF older adults, LF
older adults and younger adults, F(2,30) = 1.80, p = 0.18.
Verbal Ability. Next we examined the Shipley’s Institute of Living Scale. Seven older
adults were classified as HF, with scores between 35 and 40 (x = 38), and seven were
Table 4. Mean (and range) performance by age group: digit symbol coding
Age Group by Digit Symbol Coding Task Significance

62% 38% 28%
Accuracy (20%–100%) (0–60%) (0–73%) F (2,32)=3.58, p<.05
(60–325) (47–339) (90–351) F (2,28)=1.63, p=.21
6.34 5.06 6.39
Satisfaction (3.75–8.45) (3.55–7.55) (3.27–8.70) F (2,30)=1.80, p=.18
classified as LF, with scores between 22 and 29 (x = 27). Younger adults’ scores were
between 22 and 38 (x = 31). A one-way ANOVA revealed a significant group dif-
ference, F(2,32) = 16.55, p < 0.0001. Tukey HSD post hoc test revealed a significant
difference between HF and LF older adults (p < 0.01), a significant difference between
HF older adults and younger adults (p < 0.01), and no significant difference between
LF older adults and younger adults.
We next compared accuracy by age group and found a significant difference
between HF older adults, LF older adults and younger adults, F(2,32) = 3.57, p < 0.05.
However, Tukey HSD post hoc test revealed no significant difference in accuracy
between HF and LF older adults, between HF older adults and younger adults, and
between LF older adults and younger adults. See Table 5.
We next compared efficiency and satisfaction by age group. As with the processing
speed measures, we found no significant difference in efficiency between HF older
adults, LF older adults and younger adults, F(2,30) = 0.78, p = 0.47. For satisfaction
however, we found a significant difference among the groups, F(2,32) = 4.53, p < 0.05.
Tukey HSD post hoc test revealed a significant difference in satisfaction between HF
and LF older adults (p < 0.01), and no significant difference between HF older adults
and younger adults, and no significant difference between LF older adults and younger
adults. Thus, older adults with higher vocabulary reported lower satisfaction than their
lower vocabulary counterparts.
Table 5. Mean (and Range) Performance by Age Group: Vocabulary
Age Group by Vocabulary Task Significance

62% 44% 34%
Accuracy (20%–100%) (0–73%) (0–73%) F (2,32) = 3.57, p < .05
(60–325) (47–339) (90–439) F (2,30) = 0.78, p = .47
6.34 4.81 7.06
Satisfaction (3.75–8.45) (2.91–6.91) (3.18–8.70) F (2,32) = 4.53, p < .05
4 Conclusion
In this empirical study, we observed age-related differences in Website performance.

Consistent with other research [e.g., 22, 23 (study 3), 24] and with our first hypothesis,
older adults had lower accuracy than younger and middle-age adults. Further,
middle-age adults’ performance did not differ from either younger adults or older
adults, but older and younger adults differed. This may suggest an age-related linear
decline that is consistent with previous literature on age-related decline in cognition, in
general [11, 25] and is in-line with our second hypothesis. However, the difference may
also be due to strategy and experience differences [24], as middle-age adults often have
a wider range of both compared to younger and older adults – the “extreme” groups.
We found this difference only for the accuracy measure and not for the efficiency and
satisfaction measures.
When we split our older adults into “high-functioning” and “low functioning”
based on the backward counting task performance (processing speed), we found an
age-related difference. However, our post hoc analysis did not reveal significant dif-
ferences among the groups, even though there was a trend for older adults with slower
processing speed to complete fewer tasks successfully compared to younger adults
(32 % and 62 % respectively), and for older adults with faster processing speed (50 %)
to not differ from younger adults. We found a similar pattern for the Shipley’s
Vocabulary test: There was an overall age-related difference and a trend for older adults
with lower vocabulary to complete fewer tasks successfully compared to younger
adults, and older adults with high vocabulary to not differ from younger adults. We
believe we did not find significance in the post hoc tests because we did not have
sufficient power; the older adult groups were drastically reduced in size when we split
them into three (high, middle, lower ability). For the Digit Symbol Coding task
(processing speed), we also found a significant age-related difference. For this task,
post hoc analysis revealed a significant difference between high-functioning and
low-functioning older adults only, such that low-functioning older adults completed
fewer tasks successfully than their high-functioning counterparts.
These findings suggest that cognitive abilities may play a role in older adults’
ability to successfully complete tasks (our third hypothesis), consistent with research on
technology use more generally [17]. Here, higher cognitive abilities appeared to
mediate differences that are typically apparent with aging users. We did not find these
differences in efficiency. For satisfaction, in contrast with our fourth hypothesis, we
found that older adults with higher vocabulary reported lower satisfaction with the
Website compared to their lower vocabulary counterparts. We speculate that HF adults
may have higher expectations for the Website, and it may not have met their expec-
tations whereas LF adults may have lower expectations for the Website and hence may
be more satisfied with the site, as it may have exceeded their expectations. In addition,
we speculate that LF adults may have a tendency to blame themselves rather than the
Website for any issues they may have encountered with the site (based on anecdotal
evidence from the lab). Future work should seek to understand what participants
specifically consider when rating satisfaction and why this might differ by cognitive
ability.
In this study, we assessed the mean performance across all tasks. However, pre-
vious research shows that older adults have greater difficulties with more difficult tasks,
compared to younger adults [21, 26, 27]. Future research should couple cognitive
measures with task difficulty to understand the multitude of factors that lead to suc-
cessful user experiences for older users as well as other users with either reduced
cognitive capabilities or limited Internet experience.
This study is the first to demonstrate that cognitive ability may play a role in older
adults’ ability to complete tasks successfully. User experience researchers should
include such measures to understand participants’ cognition and ensure that people
with varying levels of processing speed and vocabulary are included in research.
Otherwise, the assumptions we make about the usability of a product may be invalid.
In conclusion, the key findings from this study are that (a) a Website designed for a
broad population of users posed problems for people of all ages, and participants could
not always find what they were searching for; (b) the difficulties were more pronounced
for older adults with lower levels of processing speed and verbal abilities. The design
implications are clear – user experience testing must include users of all ages and the
use of the site should not impose demands on processing speed and verbal ability.
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Validation of the Computer Literacy Scale (CLS)
Michael Sengpiel ✉ and Nicole Jochems

( )
Institut für Multimediale und Interaktive Systeme, Universität zu Lübeck,

23562 Lübeck, Germany
{sengpiel,jochems}@imis.uni-luebeck.de
Abstract. Successful use of ICT requires domain knowledge and interaction

knowledge. It shapes and is shaped by the use of ICT and is less common among
older adults. This paper focus on the validation of the computer literacy scale (CLS)
introduced by [14]. The CLS is an objective knowledge test of ICT-related symbols
and terms commonly used in the graphical user interface of interactive computer
technology. It has been designed specifically for older adults with little computer
knowledge and is based on the idea that knowing common symbols and terms is as
necessary for using computers, as it is for reading and writing letters and books. In
this paper the Computer literacy scale is described and compared with related meas‐
ures for example computer expertise (CE), Computer Proficiency (CPQ) and
computer anxiety (CATS). In addition criterion validity is described with predic‐
tions of successful ICT use exemplified with (1) the use of different data entry
methods and (2) the use of different ticket vending machine (TVM) designs.
Keywords: Computer literacy · Computer experience · Computer proficiency ·

Measurement · Questionnaire · Validation
1 Introduction
Successful use of ICT requires domain knowledge and interaction knowledge. The basic
interaction knowledge required for successful use of computers can be called “computer
literacy”. It shapes and is shaped by the use of ICT and is less common among older
adults.
This paper describes the validation of the computer literacy scale (CLS) introduced
by [14], following five steps. First, the CLS and related measures computer expertise
(CE), Computer Proficiency (CPQ), control beliefs regarding technology use (KUT),
attitude toward technology (ATT) and computer anxiety (CATS) are briefly described.
Second, convergent and discriminant validity is described using correlations and a prin‐
cipal component analysis (PCA). Third, criterion validity is described with predictions
of successful ICT use exemplified with (1) the use of different data entry methods and
(2) the use of different ticket vending machine (TVM) designs. Fourth, since CLS is
work in progress, the current developmental status and an outlook on upcoming proce‐
dural knowledge items and an adaptive CLS are provided. Finally, readers are encour‐
aged to use the CLS in their own research involving human computer interaction and to
contribute to the continuous validation and improvement of the CLS.

DOI: 10.1007/978-3-319-20892-3_36
366 M. Sengpiel and N. Jochems
2 Method
This paper reports results of validation studies that used CLS and other measures of
computer related user characteristics to predict successful use of diverse ICT applica‐
tions for young and old age groups in two independent applications, namely the use of
ticket vending machines (TVM, N = 124, [13]) and different data entry methods (mouse,
touch screen, eye gaze [9]) and navigation in complex information spaces (N = 90, [8]).
Convergent and discriminant validity of CLS will be reported along with psychometric
properties and correlations with user characteristics such as computer expertise (CE),
Computer Proficiency (CPQ), control beliefs regarding technology use (KUT), attitude
toward technology (ATT) and computer anxiety (CATS).
2.1 The Computer Literacy Scale (CLS)
The CLS is an objective knowledge test of ICT-related symbols and terms commonly
used in the graphical user interface of interactive computer technology. It has been
designed specifically for older adults with little computer knowledge and is based on
the idea that knowing common symbols and terms is as necessary for using computers,
as it is for reading and writing letters and books.
The CLS focuses on a small but essential aspect of computer literacy and uses it as
indicator for the broader construct: “If literacy can be considered the ability to read
symbols and use them, then computer literacy could be considered the ability to under‐
stand and use computer related symbols, functional elements and interaction patterns”
([14], p. 8). These basic building blocks of computer literacy are tested in an objective
knowledge test with 26 items (21 symbols and 5 terms) in a matching task, taking about
15 min to complete, depending on literacy level. The CLS can be downloaded for free
as printable pdf. It is available in English, German and Spanish. Figure 1 shows sample
items in the matching task.
Fig. 1. Sample items in the matching task of the CLS
2.2 The Computer Expertise Questionnaire (CE)
Based on the INCOBI computer expertise inventory by [11, 1] introduced the computer
expertise (CE) questionnaire with 18 items assessing theoretical (9 items) and practical
(9 items) computer knowledge by describing typical tasks or problems that occur using
computers and asking participants to mark the optimal course of action in a multiple
choice task with 4 alternatives [1].
Validation of the Computer Literacy Scale (CLS) 367
2.3 The “Computer Proficiency Questionnaire” (CPQ)

Later, [2] developed the “Computer Proficiency Questionnaire” (CPQ) to assess the
computer proficiency of seniors (from non-users to frequent computer and Internet
users), arguing that the CE by [1] had been developed with data from older adults who
had substantial computer experience and that the CLS by [14] had been designed for
older adults, but focused largely on declarative knowledge rather than the ability to
perform computer tasks. The CPQ consists of 33 items (there is also a short form with
12 items) that ask the respondent whether she can use technology divided in six cate‐
gories: computer basics, printer, communication, Internet, calendar and entertainment.
Thus, the CPQ is not a knowledge test but a self report measure.
2.4 Control Beliefs for Interaction with Technology (KUT)
The KUT (German akronym for “control beliefs for interaction with technology”) was
developed 1999 by [3] to extend the scope of observed user characteristics with a
personality construct that guides user actions. Participants indicated on a Likert scale of
0 (not true at all) to 4 (absolutely true) their control beliefs regarding technology use,
resulting in a maximum total score of (8 × 4 =) 32. A complete list of translated items,
including polarity, mean, variance and discriminatory power can be found in [12].
2.5 Attitude Towards Technology (ATT)
Attitude determines motivation to use technology and thus will have a direct influ‐
ence on successful use and an indirect influence through better experience and prac‐
tice [6, 15]. Attitude towards ticket vending machines was measured using an eight
item seven point semantic differential created for this study.
2.6 “Computer Anxiety Trait Scale” (CATS)

Computer anxiety and computer knowledge often show a strong negative correlation
(e.g. [10], r = −.83, p < .01, N = 222). Anxiety towards ticket vending machines was
measured using an adaptation of the “Computer Anxiety Trait Scale” (CATS) by [7],
asking the participants to imagine being at the train station wanting to use a TVM and
to rate their approval to 16 statements (e.g. “I sweat”, “My heart beats faster”) regarding
this situation on a five-point Likert scale ranging from “not at all” to “absolutely”.
3 Results
Unless marked otherwise, results regarding TVM use are from a study described by [13]
(N = 124) and those regarding different data entry methods (mouse, touch screen, eye
gaze) and navigation in complex information spaces from a study described by [8]
(N = 90).
3.1 Reliability
When the CLS was introduced [14], the quality of the computer literacy scale was
assessed with internal consistency, discrimination power and item difficulty measures.
Internal consistency was high with a Cronbach’s alpha between .93 and .96, indicating
high homogeneity, with discrimination power ranging from r = .22 to r = .84. Item
difficulty was low for the young group, but reasonably broad for the old group, ranging
from P = .13 to .87. Kolmogorov-Smirnov-Tests revealed, that the CLS scores were
normally distributed for the old group (D(39) = 0.10; p > .10) but not for the young
group (D(81) = 0.12; p < .01), for whom most items were too easy. Table 1 shows
reliability (Cronbach’s alpha) and number of items for the scales CLS, KUT, ATT,
CATS, CE and CPQ, indicating high reliability of the measures investigated.
3.2 Face Validity
Face validity of the CLS can be considered high, because the test directly asks for the
meaning of terms and symbols associated with ICT use. Test participants did not doubt
that knowing these would be relevant for successful ICT interaction. As with any objec‐
tive knowledge test, there is little impact of personality traits when compared to subjec‐
tive self report measures, which is generally perceived as an advantage.
Table 1. Scale reliability and number of items for the scales CLS, CE, CPQ, KUT, ATT and
CATS.
Scale CLS CE CPQ* KUT ATT CATS

Cronbach’s .93 .98 .88 .90 .91
Alpha
Number of 26 33 8 8 16
items
* Data based on Boot et al. (2013)
3.3 Construct Validity
3.3.1 Computer Experience and Expertise (Convergent Validity)

Computer experience is necessary but not sufficient for high computer literacy. To
capture different aspects of computer experience, it was operationalized using three
measures added on the first page of the CLS: duration (measured in years), intensity
(measured in hours per week) and diversity (measured in frequency of use for different
computer applications).
In [14] older adults reported a mean duration of 7 years using computers and a mean
intensity of 3 h per week, while younger adults reported to have used computers for a
mean duration of 10 years, which was not significantly longer than the older group, and
to spend an average of 27 h per week using computers, which was significantly more
than the older group (t(18.49) = −7.06, p < .01, r = .85). For diversity of computer use,
the older group scored M = 4.14 points while the younger group scored M = 14.69 points
(max = 21), constituting again a significant difference t(28) = −6.70, p < .01, r = 0,78).
As expected, computer experience and computer literacy were highly correlated. See
Table 2 for an overview. In order to assess the unique contribution of computer literacy
and computer experience on TVM-performance, a partial correlation analysis was
conducted. The best predictor of performance was computer literacy R2 = .37), followed
by diversity of computer experience (R2 = .25).
Table 2. Computer experience measured in duration, intensity and diversity in the older and
younger participant group and their correlation with the CLS score.
Computer Duration Intensity Diversity

experience
Old group 7 years 3 h/week** 4.14**
Young group 10 years 27 h/week 14.69
Correlation with τ = .47* τ = .51* τ = .53*
CLS
Note: *p < .05, **p < .01
As another measure of convergent validity, the relationship of the CLS and the
computer expertise questionnaire (CE, [1]) was investigated. A total of n = 90 adults
(M = 47.5 years, SD = 16.8, 36 female, 54 male) participated in a study conducted and
described in detail by [8]. Results show moderate correlations between CLS and CE
(τ = .62, p < .01), indicating that they measure related constructs, even though they do
so in very different ways.
In another study [8], a paper folding and a cube rotation test were administered
additionally to measure mental rotation ability, which is considered relevant to navigate
virtual spaces. Correlations of these measures can be seen in Table 5, indicating strong
relations between them and even stronger relations between CLS and CE (Table 3).
Table 3. Correlations for the scales CLS, CE, paper folding and the cube rotation test
Scale CLS CE Paper folding Cube rotation test

age group −.63** −.69** −.65** −.55**
CLS .77** .63** .48**
CE .61** .53**
Paper folding .65**
**Correlation is significant at the 0.01 level
Table 4. Pearson correlations for usability measures and user characteristics in the control,
videoand wizard conditions
Usability TVM N Age CLS KUT ATT CATS

Measure
Effectiveness original 32 –.54** .61*** .21 .48** –.49**
video 35 –.49** .50** .30* .41** –.20
wizard 35 .05 .05 –.08 –.09 .09
Efficiency original 32 –.69*** .67*** .41* .43** –.46**
(time)
video 35 –.78*** .70*** .35* .52** –.35*
wizard 35 –.66*** .63*** .47** .44** –.45**
Efficiency original 32 –.56*** .60*** .25 .50** –.51**
(steps)
video 35 –.42** .36* .12 .29* –.05
wizard 35 –.01 .04 .05 .00 .07
Satisfaction original 32 –.26 .49 .43** .49** –.47**
video 35 –.27 –.01 .12 .15 –.26
wizard 35 .15 .21 .29* .15 –.36*
Correlation is significant at the ***0.001 / **0.01 / *0.05 level
3.3.2 Discriminant Validity

It was expected that besides computer literacy (CLS), interaction with computers would
also be related to other user characteristics such as control beliefs regarding the use of
technology (KUT), attitude toward technology (ATT) and computer anxiety (CATS).
As Table 4 shows, these user characteristics were indeed highly correlated with Pearson
correlations between .46** and −.73**.
To test whether the 58 items taken from these ICT use related scales actually meas‐
ured distinct traits, a principal component analysis (PCA) with varimax rotation (with
Kaiser normalization procedure) was conducted (total sample N = 124). The Kaiser-
Meyer-Olkin measure confirmed sampling adequacy for the analysis with KMO = .82
and Bartlett’s test of sphericity χ2(1653) = 4643.59, p < .001, indicated that correlations
between items were sufficiently large for PCA. Four factors that explained 48.6 % of
variance in all items were extracted. The rotated factor matrix in table A1 (appendix)
shows that all items loaded on the appropriate latent constructs (indicated by bold
values), confirming the factorial validity of the different scales.
Table 5. Pearson correlations (above the diagonal) and significance values (below the diag‐
onal)for usability measures (N = 124, except for satisfaction N = 118) and user characteristics
(N = 102,except for satisfaction N = 98)
3.4 Criterion Validity
A central question regarding the validity of the CLS is: How well does it predict actual
success in ICT use? Success in TVM use was operationalized according to the usability
criteria [5] effectiveness (in solving 11 tasks using the TVM to select tickets), efficiency
(measured in the time and the steps needed to solve the tasks) and satisfaction (measured
as the mean score of 13 items based on the Questionnaire for User Interface Satisfaction
(QUIS) by [4]). ICT use was operationalized using three different TVM designs: (1) a
simulation of the original TVM as used by the Berlin Public Transport System (2) the
same TVM with a brief (2:37 min) instructional video before use and (3) a wizard rede‐
sign of the TVM that maintained the same functionality but was designed to require less
computer literacy to be universally usable (see [13]) for details).
To estimate the impact of the user characteristics on usability measures in the original
TVM, video and wizard conditions, first separate Pearson correlations are reported (see
Table 4).
Using the original TVM, age was strongly related to effectiveness and efficiency but
not to satisfaction. The same is true for the video condition, showing very similar if a
little weaker negative correlations. The wizard redesign however shows no significant
correlations between age and effectiveness, efficiency (steps) or satisfaction, indicating
successful inclusive design - only the correlation to efficiency (time) persists. Interest‐
ingly, this pattern is largely replicated with the other user characteristics. Table 5 shows
correlations between usability measures and user characteristics over all TVM designs,
indicating that CLS has the strongest correlations with all usability measures.
Finally, a hierachical multiple regression with blockwise entry of (1) age (2) CLS
and (3) KUT, ATT, CATS was conducted to estimate the degree to which these user
characteristics predict effectiveness, efficiency and satisfaction, of which only effec‐
tiveness shall be reported here. As results presented in Table 6 show, age was a
strong predictor of effective use of the original TVM with a β = −.54**. Yet if the
CLS score was entered into the regression model, the impact of age was reduced to
a non-significant β = −.17 and CLS was the best predictor (with β = .48m). CLS
remained the best predictor after KUT, ATT and CATS had been added in a third
step. For the video and the wizard condition, the impact of these user characteristics
was reduced, indicating that the design changes lowered some barriers to successful
TVM use. Thus especially the wizard came close to the goal of universal usability.
See Table 6 for an overview of the results of the hierarchical regression.
In another study [8] CLS and CE were administered before participants used a project
planning software with four different layouts (control layout, Overview window, detail
window and zoom function). In Table 7 the correlations between CLS, CE and the
number of mistakes are presented. Table 8 described the correlations between CLS, CE
and total execution time, participants needed to solve the tasks with the help of the
different layouts. As you can see in Table 7, both, CLS and CE predict the number of
mistakes. Regarding the execution time interesting results could be found (Table 8). In
this case, only the CLS scale predicts total execution time.
4 Discussion
It is argued that ultimately, computer literacy could have an impact on any ICT-inter‐
action and thus it should be measured as control variable in any study using ICT.
Table 6. Effects of age, CLS, KUT, ATT and CATS on effectiveness for original TVM, video
andwizard re-design
Block Condition TVM, N=32 Video, N=35 Wizard, N=35

model R2 .481 .332 .043
β sr2 β sr2 β sr2
1 ∆R2 .295** .236** .002
age –.54** .29 –.49** .24 .05 <.01

2 ∆R2 .088m .037 .015
age –.17 .01 –.25 .02 .18 .01

CLS .48m .09 .31 .04 .18 .01
3 ∆R2 .098 .059 .026
age –.17 .01 –.18 .01 .23 .02

CLS .37 .04 .30 .04 .35 .03
KUT –.14 .01 .15 .02 –.15 .01
ATT .20 .02 .26 .02 .11 <.01
CATS –.20 .02 .30 .04 .15 .01
Note: ***p<.001, **p<.01, *p<.05, mp<.10
The CLS has shown to be a reliable and valid measure of computer literacy. It can
be used to assess the computer literacy of a person as well as the computer literacy
requirements of a user interface design.
Since symbols and terms used in human computer interaction change quickly, it
remains a constant challenge to update and improve the CLS. From the beginning of the
CLS development it was a central goal to improve computer literacy assessment with
an objective knowledge test rather than subjective self report measure. With the ongoing
development of the CLS, the test of declarative knowledge described above has been
extended with a procedural knowledge test, in which users are asked to complete tasks
online that require computer literacy [16]. Figure 2 shows screenshots of two of these
tasks, booking a flight (left) and mixing colors (right).
Table 7. Correlations for the scales CLS and CE with the number of mistakes in the four inves‐
tigated layouts.
Number of Control Overview Detail Zoom function

mistakes in layout window window
Computer −.36** −.43** −.37** −.28**
Expertise
Computer −.33** −.34** −.21 −.19
Literacy
Table 8. Correlations for the scales CLS and CE with the total execution time in the four inves‐
tigated layouts.
Total execution Control Overview Detail Zoom function

time in layout window window
Computer −.02 .03 −.01 .01
Expertise
Computer −.61** −.45** −.48** −.34**
Literacy
Currently, efforts are directed at making an adaptive CLS available online, which
will reduce testing time to about 3 min, without compromising reliability or validity of
the results. The item base has been extended to over 120 items that have been tested and
selected for conformity to the RASCH model, providing a solid base for adaptive testing.
Figure 3 shows screenshots with sample items from the current prototype of the adaptive
CLS. The adaptive CLS will be available shortly at www.computer-literacy.net. We
invite everyone to use it in their own studies and would appreciate any feedback
regarding the CLS that helps us to continually improve it.
Fig. 2. Screenshots of two tasks for the extended CLS, designed to test procedural computer
interaction knowledge. The task on the left is to book a flight, on the right colors are to be chosen
to mix a paint.
Fig. 3. Screenshots with sample items from the current prototype of the adaptive CLS
Acknowledgments. We thank all those involved in the development of the CLS, especially
Diana Dittberner, Nadezda Arsenyeva, Susan Götzinger, Maria Spiering and Nico Zeissig.
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Age(ism) in Digital Information Provision:
The Case of Online Public Services
for Older Adults
Maria Sourbati(&)
School of Art, Design and Media, College of Arts and Humanities,

University of Brighton, Brighton, UK
[email protected]
Abstract. This paper draws on an empirical investigation of how older people

are represented on the websites providing social care service information in the
inner London Boroughs. My research questions follow the work of Loos [1, 2]
on the relationship between representations of older age, information accessi-
bility and access to digital services. Mirroring Loos and reflecting the speci-
ficities of the fieldwork my investigation found older people were largely
invisible as a diverse group of citizens in the emerging cultures of digital public
service. The images of older adults were few and lacked diversity. Inner London
has an ethnically and culturally diverse population yet older adults were com-
monly represented though images of frail white women. The paper highlights
representational politics of older age in digital public service information pro-
vision and their consequences for access and social inclusion; intra-generational
diversity; ageism as a prevalent form of social discrimination.
Keywords: Age Ageism Access Inclusion Digital public service

Intragenerational diversity
1 Introduction
This paper draws on an empirical investigation of digital information provision in local

government websites to discuss older age, diversity and inclusion in digital public
service. Its broader context is the constant increase of ICT innovation, media use and
ageing. As an ever increasing range of interpersonal, professional and civic commu-
nication activity is today digitally mediated, access to digital information services for a
diverse population is essential to transact with government and market actors. In digital
information services such as healthcare, mechanisms that control or facilitate our access
to the media-technology interfaces (e.g., navigation systems, website design including
the representation of their target users) have an impact on our access to services that
support independent living, good life and life in the community etc. Media access and
diversity are therefore gaining renewed currency. The ‘digital turn’ can be seen to
increase the relevance of those legacy media policy values as well as the complexity
and elusiveness that characterizes their implementation. The ageing turn, which is
inscribed in the biological and social logic of ageing in our society [3, pp. 94, 102]

DOI: 10.1007/978-3-319-20892-3_37
Age(ism) in Digital Information Provision: The Case of Online Public Services 377
further accentuates them. This paper is a contribution to the policy discussion of digital
media access for a diverse population of older people [1, 2, 4, 5] in our ageing and
ageist societies.
The more specific context of the paper relates UK government’s ‘digital by default’
strategy to deliver public service information online/digital only. According to the 2013
Government Digital Strategy [Executive Summary, 6] the UK public sector is now
moving from multiple channels to delivery of public service information that is
online/digital1 only. Having committed to a target of digital by default public services
by March 2015 [6] the strategy aimed to increase delivery of their services online by
increasing the level of use of digital public services. According to government ‘Digital
by Default’ wishes to encourage everyone who can use digital services independently
to do so. For those who cannot use digital ICTs for themselves digital information
provision will be implemented by assisted digital use, whereby individuals can access a
service with help by proxy users. Government has declared assisted access (‘assisted
digital’) will be the only ‘non-digital’ way to access services for the people who use
government services but are not able to use digital services independently [6, 7]. Social
health care information services are a core area of public service provision. The ide-
ology of the government strategy of digital social policy can be summarized as ‘fair
access to services for those who are entitled to them.’ [7]. Defined that way, ‘fair’
access is subject to availability of media-technological infrastructure, including internet
connectivity, and digital information provision to a diversity of users. It will be
determined by policy responses to understanding of who the users are, who can and
who cannot use digital services – perceptions of accessibility, diversity, and infor-
mation provision to a potential diversity of users.
The remainder of this paper discusses conceptualizations of older age in research
and trends in internet use and the social demographics of the older adult population in
the UK, and reports the findings of a study of older adults’ representations in Local
Authority social care service webpages. The final section discusses the findings and
concludes the paper.
2 Media Technologies and the Perils of Abstracted,

Temporally Bound Age
Older people are a large and growing group. We commonly refer to older adults as a
single generational group, membership of which is defined by a shared chronological
location. Frequently used to mean ‘cohort’ the term [older] generation defines people in
terms of a specific chronological age range [8, pp. 31, 33]. Oddly, we take this common
1
Information services are defined by government as covering the publishing of information to help citizens
and businesses in their engagement with government (https://www.gov.uk/government/publications/
government-digital-strategy/government-digital-strategy#introduction). ‘Digital’ is meant as a synonym to
‘online’. The policy glossary reads: ‘By ‘digital’, we mean internet-enabled; such as desktop, laptop, tablet,
mobile or digital devices not yet invented’ (Government Digital Strategy, 10/12/2013 https://www.gov.uk/
government/publications/government-digital-strategy/government-digital-strategy#annex-1-glossary).
378 M. Sourbati
location to span five decades of birth dates, from 50+ to 100+ years. We then con-
ceptualize age on the basis of assumptions of homogenous context. This politics is
reproduced in media and ICT research though practical reasons that often inhibit
research on the 70+ year-olds using popular research tools (e.g. limitations of telephone
surveys: people living in retirement or residential homes without individual phone line
are hard to get hold of) [9 p. 3]. When it comes to the use of new media technologies
older people are treated as ‘residual category’ encompassing all ages above 50 or 60
years [9, p. 13]. Popular labels of digital natives and immigrants [10] can be seen to
play upon exactly this abstraction and related socio-technical and life-world dichoto-
mies, which are beyond the scope of this conference paper to discuss.
Society, research and policy communities are waking up to age. More recent
empirical investigations of older/younger people and new ICTs have exposed sub-
stantial limitations in dominant conceptualizations of media-technological and age
boundaries and the assumed clear-cut temporal-and spatial divisions in media use [1, 2,
4, 5, 9, 11, 12]. This new and growing body of research examines the contexts of the
lived experience of age including the variability of media technology and internal
diversity or intra-age variability [11]. Older people encompass an ‘incredibly diverse’
group of users of media technologies in terms of characteristics and functionality [13,
p. 152], life events and experiences of education, jobs held, relational/familial networks
and all forms of cultural capital. Differences tend to increase with age as a result of
increased variability in cumulative life experiences [14, p. 68; 10, p. 265; 15, pp. 109–
110] according to the concept of ‘aged heterogeneity’, originally used by Dannefer [16,
pp. 360–362]. There is also a growing polarisation among people belonging in the
same age group, particularly during the last part of the life course. Many older groups
experience a restriction in social space and limited choice in access to adequate
housing, leisure, health and communication infrastructure etc. [8, pp. 129–130]. Sig-
nificant inequalities within the older population including functions of education, such
as sex/gender can determine their place and location in the new technology landscape
[3, pp. 101–102].
3 Intra-generational Variability: Sex, Ethnic Origin

and the Internet
The body of older internet users grows constantly. Official internet use statistics reflect
this increase in the ageing of media users. A majority of older people in the UK are using
the internet today. In 2013 fifty nine per cent (59 %) of people aged over 65 were online
(https://www.gov.uk/government/publications/digital-landscape-research/digital-lands-
cape-research). According to the UK Office of National Statistics seven in ten of those
aged 65 to 74 and four out of ten adults aged 75+ had used the internet in 2014 [17]
http://www.ons.gov.uk/ons/rel/rdit2/internet-access-quarterly-update/q1-2014/stb-ia-q1
-2014.html#tab-Age. Seventy-one per cent of adults aged 65–74 had used the internet in
Q1 2014 and thirty-seven per cent of adults aged 75 years and over, the latter category
representing 1.8 million people. Socio-demographic data for older users reveal areas of
inequality which are commonly understood as a thing of the past in countries with high
internet diffusion. Sex is a notable one. Like race and ethnicity, sex it is no longer
considered by the ‘digital divide’ research as a factor of social different in internet usage
in the UK [18]. According to national statistics there is little difference in internet use
between men and women in all groups under 65 years of age [17]. However, sex appears
to determine access to the internet among older groups. Men over the age of 75 are twice
as likely to use the internet compared to women of the same age [19] In 2014 five in ten
men aged 75+ had used the internet against three in every ten women in the same age
group [17].
These differences can be understood as functions of inequality in education and
wealth/social position, which have been a constant backdrop in adults’ engagement
with digital media. Of about 18 % of the UK population who had never used the
internet in 2013, blue collar non-users were more likely than other groups to identify
age (78 %) as reasons not to use the Internet [20, p. 55]. By contrast 95 per cent of all
adults with a higher educational qualification had used the internet in the UK [20,
p. 19]. The relevance of education and social position and suggested correlations of
age, sex and education in the UK mirror similar trends in international data [9].
Older adult cohorts are today becoming more ethnically diverse in the UK.
According to the ONS [19] the 2011 census data show that between 2001 and 2011 the
65 and over age group became slightly more ethnically diverse. The older population
identifying as White British increased in size from 7.8 million to 8.5 million but the
proportion of the age group they accounted for decreased from 94 % in 2001 to 92 % in
2011. This compares with much larger changes in the under 65 age group, which saw
the proportion of the population who were White British decrease from 86 % in 2001 to
72 % in 2011 (p. 9 in http://www.ons.gov.uk/ons/dcp171776_342117.pdf) Ethnic
diversity is far greater in the city of London. Tables 1 and 2 present the ethnic
breakdown (White/Black & Other Minority Ethnic, BAME) of adult populations aged
over 65 years and of the total population of city residents in the twelve inner London
Boroughs, based on data made available by the Greater London Authority in 2013
(http://data.london.gov.uk/datastore/applications/custom-age-range-creator-tool-gla-
ethnic-group-population-projections-borough.
An increase in the ethnic diversity of the adult population is manifested online too,
in the limited data made available by the ONS, which indicate the highest rates of
internet use (over 90 %) among adults who indicated that their ethnic group was Mixed
ethnic, Chinese, Black, or Other. The Pakistani ethnic group remained the group with
the lowest rate of use (82 %) in Q1 2014. (ONS, Internet Access Quarterly update Q1
2014 http://www.ons.gov.uk/ons/rel/rdit2/internet-access-quarterly-update/q1-2014/
stb-ia-q1-2014.html#tab-Ethnic-Group).
In short, according to national statistics older age cohorts become more heteroge-
neous across the UK. On the internet, sex (‘gender’) remains a manifestation of dis-
crimination among the older adults who are 75+ and there is a strong correlation with
sex, age, and education and internet use. Differences based on sex tend to be con-
founded with other factors determined by the respondents sex: ‘Among this generation,
the correlation of sex with education and income is stronger compared to later gen-
erations for which educational opportunities were more equal’ [9, p. 13] Lastly the
limited available data indicate a possibly divergent trend of higher levels of internet use
among non-white, ‘minority ethnic’ adult groups.
380 M. Sourbati
Table 1. Inner London population by ethnic origin (White/BAME) data source GLA 2013
Table 2. Ethnic origin (white /BAME) 65+ year olds by Borough. Data source GLA 2013
4 Older People in Digital Public Service Information

Provision
The increase in the age, heterogeneity and diversity of adult internet users has been the
backdrop to my examination of how older adults are represented visually on local
government websites providing information about adult social care support services.
Social care support services are provided at local authority level. Access to this kind of
support services has been universal, with all UK residents able to use these services.
This exploratory study was undertaken in December 2013, as the migration of public
service information provision online was underway. The study examined how older
adults are represented visually, though the use of pictures and photographs, in the adult
social care portal/homepage of in the twelve inner city London Boroughs (Camden,
Greenwich, Islington, Lambeth, Lewisham, Southwark, Kensington and Chelsea,
Fulham, Tower Hamlets, Hackney, Wandsworth, Westminster) giving a snapshot of
cultural attitudes to age in public policy. My research questions follow the work of
Loos [1, 2] on older age, information accessibility and the relationship between rep-
resentations and access to digital services.
A widespread practice in the Borough homepages was to show one or two images of
mostly frail looking older people to illustrate their general ID/theme. This was the case of
Tower Hamlets2 (http://www.towerhamlets.gov.uk/lgnl/health_and_social_care.aspx),
Greenwich (http://www.royalgreenwich.gov.uk/info/200050/help_for_adults) Ham
mersmith and Fulham (http://www.lbhf.gov.uk/Directory/Health_and_Social_Care/
Services_for_the_elderly/homepage.asp), Lambeth3 (http://www.Lambeth.gov.uk/
Services/HealthSocialCare/ServicesAdults/) (Figs. 1 and 2).
Two trends can be seen in these screenshots: One, there is a restricted visibility of
older people in those websites. Images depicting older adults are limited in number.
Two, when older people become visible, for example in the updated versions of
Council websites, they are depicted as frail, white older women, not making visible
potential differences based on sex, ethnic background and vitality. The webpages of
Greenwich and Lambeth included some characteristically ageist representations (older
lady and fruit assortment on the Greenwich page; a Polaroid picture of young adult
woman and man doing craftwork in 1980 s’ fashion fancy dress on the Lambeth page).
The Greenwich social care services website is now redesigned and shows an image of
two pairs of hands – the young ones holding the very old ones. In Islington older adults
are not visible through images (no depiction of older adults) as all information is
text-based (http://www.islington.gov.uk/services/social-care-health/older-people/Pag-
es/default.aspx?extra=4). The websites of Wandsworth (http://www.wandsworth.gov.
uk/homepage/146/adult_care_information_service) and Southwark (http://www.south-
wark.gov.uk/info/200387/assessments_benefits_and_advice) were in the process of
2
This website has now been redesigned and uses icon to represent services and users.
3
The Lambeth pages (http://www.lambeth.gov.uk/Services/HealthSocialCare/ServicesAdults) were
redesigned in summer 2014.
382 M. Sourbati
Fig. 1. Screenshot of Greenwich Adult Social Care Homepage December 2013
Fig. 2. Screenshot of Greenwich Adult Social Care Homepage January 2015

adopting a new, more visually oriented online information provision strategy. The
Southwark social care home page shows eight older women and men, of which six are
white and two are black or mixed race. The Wandsworth Borough page uses graphic
icons as navigation buttons and there are no image depicting older people in the main
menu of choices.
Two London Boroughs, Camden and Lewisham have implemented a new visual
design with simplified, integrated one stop shop services: These Council services make
older people visible and recognizable on their homepages. Power relationships of
inclusion/exclusion and centring/marginalization can also be observed here. Camden
(http://camdencarechoices.camden.gov.uk/) has implemented inclusive and experiential
understandings of adult ageing. In the Camden site inclusive social demographics made
visible though a lens of dynamic diversity.
Camden includes a spectrum of representations with adults of all ages, a range of
ethnic groups and equally split sexes (eight women and eight men). By contrast the
Lewisham homepage (http://www.lewishammylifemychoice.org.uk/) features a white
elderly couple (woman and man). Westminster and Kensington and Chelsea provide
both legacy websites and a new, common partnership service called People First http://
www.peoplefirstinfo.org.uk/. This external website represents a flagship project which
follows current priorities in the reorganization of social health and care services as
formalized in the 2014 Care Act, which incorporates Digital by Default design
requirements. Lambeth and Southwark are now running a joint social care services
information provision and their newly designed website (http://directory.ageuklambeth.
org.uk/) is visually inclusive: Images of a multi-ethnic groups of older adults are used,
both vitality and frailness women and men (Figs. 3 and 4).
Fig. 3. Screenshot of Lewisham Guide to Social Care

384 M. Sourbati
Fig. 4. Screenshot of Camden Care Choices
5 Discussion and Conclusions: Digital Public Service

and the Invisible Older Users
All twelve Inner London Boroughs provide online information about adult social care,
most through dedicated pages. At the time of the research some Boroughs, and more
generally local authorities across the country have been redesigning their web services,
to meet digital by default targets and therefore the sample provided a good mix of what
I’d call ‘commonsense’ age(ist) values (Greenwich; Lewisham) as well as some newer
interpretations of digital inclusion (Camden; Southwark). This study found stereotyp-
ical understandings of older age being standing in the wrong end of a ‘digital divide’
(information ‘have-nots’, digital ‘can-nots’) in the visual design of information pro-
vision of the local authority websites. The study also found a newly emerging more
inclusive visual representation of the age spectrum of adulthood has been in the
websites of some Boroughs (Camden).
Two common visual representations were of old older people as either invisible or
non-users of a digital information resource (no pictures as in the case of Islington and
Wandsworth) or limited and partial, depicting mostly frail white women. Yet behind
this limited and exclusionary representation of older groups of different ages, is a
diverse and complex set of differences, both in social demographics and in patterns of
internet use as section three showed. Internet use patterns can be seen as functions of
inequalities of access to education and cultural and social resources, translating to
unequal opportunities to employment for women and men, including ‘first generation’
immigrants, in the case of people over the age of 75. Translating this complex set of
inequalities, and the diversity in the life-world experience of those people to homog-
enized representations of the old as frail non users of the internet can be seen as
unhelpful to access a crude politics of ageism. Recently published studies [e.g. 9, 20]
have demonstrated how social position and the social context appears to have a
manifold influence on internet use among the older groups of people aged 70+ with the
lower levels of internet use. In Friemel’s study [9] gender differences in usage, which in
the UK ONS data examined in the present study [16, 20] are the most pronounced
among internet users aged 75+, were found to disappear if controlled for education,
income, technical interest, pre-retirement computer use and marital status. Heatmaps in
an eye-tracking study conducted by Loos [12] showed clearly that the navigation
patterns of older participants with a high frequency of internet use were quite similar to
those of younger ones (see also Hill et al. [21] Dutton et al. [20] demonstrate this for
education: virtually all with a higher education degree are using the internet.
Homogenous representations of the relationship of older age and new media use may
mask, augment and further reinforce disadvantage experienced by older cohorts.
Culturally entrenched ageist attitudes, institutionalized practice and research design
bias can reinforce the marginalization of older people and reproduce patterns of
inequality, including along lines of race and sex.
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experience counts. In: CHI 2011, Vancouver, BC, Canada 7–12 May 2011 (2011)
A Framework for Evaluating
the Implementers’ Experience in Making
Existing Products Accessible:
The Prosperity4all Approach
Katerina Touliou1(&), Maria Gemou1, Till Riedel2, Maria Panou1,

and Evangelos Bekiaris1
1
Centre for Research and Technology/Hellenic Institute of Transport
(CERTH/HIT), Athens, Greece
{touliouk,mgemou,mpanou,abek}@certh.gr
2
Karlsruhe Institute of Technology (KIT), Karlsruhe, Germany
[email protected]
Abstract. Prosperity4All is a continuous and dynamic paradigm shift towards

an e-inclusion framework building on the architectural and technical foundations
of other Global Public Inclusive Infrastructure (GPII) projects aiming to create a
self-sustainable and growing ecosystem where developers, implementers, con-
sumers, prosumers and other directly and indirectly actors (e.g. teachers, carers,
clinicians) may play a role in its viability and diversity. An agile and dynamic
approach is adopted in three evaluation phases, starting with formative evalu-
ations with five internal implementers leading to more summative techniques
towards the final evaluation phase where more (n = 25) and external profes-
sionals will use the tools and resources available in the project’s repository
(DeveloperSpace) to improve and enhance their own products and services. The
evaluation approach for the implementers considers three dimensions: (a) the
project’s Key Performance Indicators (KPIs), (b) technical validation activities
prior evaluation, and (c) three evaluation phases followed by a final impact
assessment.
Keywords: Inclusive design Implementers Evaluation Accessibility

Ecosystem
1 Introduction
Prosperity4All is a continuous and dynamic paradigm shift towards an e-inclusion

framework building on the architectural and technical foundations of other Global
Public Inclusive Infrastructure (GPII) projects by creating a self-sustainable and
growing ecosystem, where developers, implementers, consumers, prosumers and other
directly and indirectly actors (e.g. teachers, carers, clinicians) may interact with and
play a role in its viability and diversity. The Global Public Inclusive Infrastructure
(GPII) is a project of Raising the Floor, a consortium of academic, industry, and
non-governmental organizations and individuals (http://gpii.net/). The GPII will

DOI: 10.1007/978-3-319-20892-3_38
388 K. Touliou et al.
combine cloud computing, web, and platform services to make access simpler, more
inclusive, available everywhere, and more affordable. When completed it will provide
the infrastructure needed to make it possible for companies, organizations, and society
to put the web within reach of all - by making it easier and less expensive for con-
sumers with disabilities, ICT and AT companies, Public Access Points, employers,
educators, government agencies and others to create, disseminate, and support acces-
sibility across technologies.
In particular, the aim of Prosperity4All is to provide an infrastructure for the devel-
opment of an ecosystem by employing modern and new techniques, like crowdsourcing
and gamification, to enable new strategies for developing accessibility services and
introduce a new approach to accessibility solution development. This ecosystem will
allow seamless, efficient, cost-effective and unobtrusive communication between
developers, implementers, consumers and prosumers. Consumers will be able to com-
municate with developers and implementers for ordering personalized and customized
products and solutions (e.g. web-based business solutions customized for visual impaired
users). However, with such diversity comes complexity that substantially affects the
designing and planning process for the respective evaluation approach and framework.
The evaluation of the ecosystem will be achieved through impact estimations of its
deployment. Before reaching the point to estimate small or large potential impacts,
actuals evaluations will be carried out in three pilot sites in Europe; Austria, Germany,
Greece, Spain with real users and implementers. The evaluations with implementers
precede any testing with real end-users. The final evaluation phase with implementers
will be the first evaluation phase with end-users. Evaluations with implementers will be
performed with at least thirty users in different sites, including both internal to the
project participants and externals for the second and third evaluation phase. The
objectives and the Key Performance Indicators (KPIs) were the driving forces for
drafting the evaluation questions to be considered and set.
1.1 The Overarching Evaluation Questions

Defining the questions to ask was a first step. The evaluation questions had to
accommodate for the project’s KPIs and the latter reflected the objectives. All three
were mapped before overarching questions were prepared. Thus, a top-down approach
was followed for the evaluation questions of the framework.
1. Are the tools/resources for Developers (DeveloperSpace and all of the frameworks,
components, marketing tools, etc.) usable by and useful to developers/implementers
(both internal developers and external developers, implementers)?
2. Do the tools/resources help implementers in their work or decrease cost to develop
or increase market size/share? OR increase profits?
Evidently, the evaluation focusses not only on the utility and use of these tools and
resources but also on their cost-efficiency in their everyday work. Therefore, imple-
menter’s previous experience with and involvement in accessibility work and projects
is of importance. A bottom-up process is applied for preparing the actual evaluation
materials were specific instruments are selected.
A Framework for Evaluating the Implementers’ 389
1.2 The Evaluation Framework for Implementers

Developing an inclusive and human-oriented framework that will adapt dynamic and
agile methods and will be embedded in the development lifecycle, to the extent this is
possible, is a challenging endeavor for planning the evaluation but as well as collecting
data and draw inferences on the outcomes. Early evaluations are mostly formative
leading later on to more summative efforts. The final evaluation phase will coincide
with the first iteration with end-users and then their inter-play will be captured with
pluralistic techniques.
There is keen interest in identified how cost-efficient and viable will be this eco-
system for professionals working in diverse areas (e.g. web developers, hobbyists, etc.)
in order to offer customized and personalized solutions to people with diverse and
sometimes complex accessibility needs, aiming to address the tails-of-the-tails of
populations of users they might be isolated by existing practices and offered market-
place solutions. The evaluation framework addresses different users-actors based on
their functional role which they may play in the ecosystem. The roles might as well be
interchangeable when the ecosystem will be deployed, after all evaluations finish and
optimization is achieved; wherever relevant and applicable.
Building up the evaluation framework requires knowledge in the areas of traditional
usability and user experience testing and insight in customer perception and
e-commerce marketing analytics. Most of the project’s applications and services are
already offered to consumers and therefore they will not be evaluated per se. On the
contrary, the tools developed or improved during the project - tools and frameworks
with Graphical User Interfaces for Development (IDEs), building blocks and frame-
works (with no graphical interfaces) for developers (APIs), and web-based developer
resources- will be available at a specially design repository, the DeveloperSpace.
Fig. 1. The implementers’ evaluation framework

The three evaluation activities will be harmonized with the enhancing development
cycle. Firstly, the implementers will search the DeveloperSpace to find the appropriate
tools and resources in order to add functionalities to their products and services for
making them more accessible or adding functionalities that will make them even more
accessible to users with other accessibility needs. The evaluation framework is “sur-
rounded” by other activities (Fig. 1) as the inter-connections and inter-dependencies
between the evaluations and the following project activities are necessary:
(a) the ecosystem’s business cases defined by the demand and supply chains for the
future actors in the alive ecosystem;
(b) the tools (e.g. developer-facing with interfaces like certain APIs) and resources
chosen and used by implementers that reside in the DeveloperSpace; and
(c) the actual products that will be improved, representing different areas of interest
and life activities (e.g. business, health, education).
The logical model prepared for the evaluation activities with implementers includes the
input namely the actors and the developments, the process being the evaluation
activities including recruitment and technical validation whenever and wherever rele-
vant, and the outcomes being the collection of the indicators by using formative
methods in the first iteration (i.e. pluralistic walkthroughs and workshops with
emphasis on implementers’ decision-making processes and utility of tools) and more
summative in later stages (cost and time efficiency estimations and matching the
expectations of developers with different levels of experience in accessibility with their
post-responses).
2 Methodology
The methodological approach adopted includes three inter-dependent dimensions:

(a) objectives as set by the Key Performance Indicators (KPIs) of the project,
(b) technical validation prior any testing takes place, (c) three evaluation phases, and a
final impact assessment. The evaluation framework led to the design of a logical model
specifically for testing with developers taking into consideration these three evaluation
dimensions and two meta-evaluation aspects which are important for the
self-sustainability of the ecosystem and, thus, for its prosperity; an agile feedback loop
utilizing contemporary web tools such as JIRAs and a meta-evaluation assessment
carried out after the end of each phase (i.e. structured lesson learnt method based on
pre-defined mitigation planning). The implementers’ logical model addresses the fol-
lowing for each category of developments (IDEs, APIs, etc.): (a) a higher objective;
e.g. matching of notations and graphical elements regarding relevant user, (b) indica-
tors/constructs; e.g. 12 cognitive dimensions; abstraction gradient, closeness of map-
ping, consistency, etc., based on Cognitive Dimensions Theory [1], (c) evaluation
technique (e.g. scenario-based cognitive analysis); (d) evaluation instrument/tools;
e.g. cognitive dimensions’ questionnaire [2], and success thresholds & criteria; e.g.
approximate matching dimensions.
The developers are interested in how these tools match the process and applications
(matchmaking) and how much they will save in money and time when using those
tools (cost-effectiveness). These are also considered, as we want to understand how the
developers will reach the decision to use the tools (i.e. revealing the decision making
process) and which is the reference case (i.e. their professional preferences and deci-
sions to use certain tools over others in their work environment). The evaluation
focuses on measuring how usable and useful will be the DeveloperSpace and all of the
frameworks, components, and tools for internal and external implementers, with con-
sideration for how helpful they will be, how much they will decrease the cost to
develop, and how much they will increase profits and market size. The last two aspects
will be addressed by the impact assessment carried out after the deployment of Pros-
perity4All ecosystem. The professional experience of developers and implementers
participating in the pilots in inclusive design and accessibility is taken into consider-
ation. Three iteration phases will be carried out starting with a small group of internal
implementers (N = 5) for the first iteration phase and gradually including external
implementers in the last two (N = 25). Peer reviews and automatic documentation
improvements are common qualitative methods for evaluating solution for developers.
These methods have restricted transferability and therefore potential validity. Instead,
heuristic walkthroughs and relevant formative techniques will be used in the first
iteration. Summative evaluation will mostly take place in the iterations to follow;
especially when the Prosperity4All platform will be deployed and analytics will be
gathered from real life interaction with it.
2.1 Actors
Implementers are the Prosperity4All actors who will incorporate the tools and resources
offered to them in the DeveloperSpace in order to make their applications and services
more accessible or to improve the user experience of already accessible applications.
Implementers are both the internal implementers and external professionals who might
be freelancers or even companies, service providers, and other groups as identified in
the list of actors (Table 1).
In these user groups, developers who will directly add outcomes to their applica-
tions and use existing resources during the improvement process (enhancement
Table 1. Primary categories of implementers

1. AT Developers 4. Researchers
• Hardware AT • University/College/Tech-Institute
• Software AT (install) • Other technology-oriented education
• Web/Cloud AT 5. Community Developers
2. Mainstream Developers • Micro Service Developers
• Desktop Applications • Friends and Family
• Web/Cloud Applications • Prosumers
• Cloud Service Providers 6. Service Delivery Professionals
• Hardware/Appliances • Clinicians
• Mobile Applications • Teachers
3. System Integrators
development lifecycle), their implementation will also evaluate this work and imple-
menters will evaluate the utility –among other attributes-of the resources they will
choose to “accessibilize” their products. The participants are sought to be representa-
tive of a bigger group of “implanters” that need to be considered in the wider scope
(Table 1).
Other stakeholders may be influenced by the implementer’s perspective of the
DeveloperSPace; this particularly includes the government. Governmental agencies are
setting the regulatory frame for many implementations as well as do procurement
officers or decision makers. They highly influence what will be considered for
implementation. The evaluation acknowledges that roles may be fluid, so that also
consumers with decision making powers have influence on implementation decisions
and that particularly prosumers are interesting stakeholders in the realm of accessibility.
One underlying assumption of the evaluation framework is, however, that the imple-
menters’ perspective on Prosperity4All is common but very heterogeneous for all the
stakeholders.
Examples of Generic Personas and Application Scenarios for Implementers.
Based on the list of actors, application scenarios like short stories are created for three
groups of actors which belong to the producer category (i.e. people who produce
products, create applications, improve services, etc.) and have a direct impact to the
Prosperity4All developments (i.e. belong to the family of Producer of Things (PoTs)
scenarios). They were created for three different value propositions (i.e. reasons to join
platform). At this stage, scenarios are characterized by the functional role of the
stakeholder, the value proposition (broad), and the family of scenarios it belongs.
The value of these scenarios for the evaluation framework lies in the fact that they
provide insight in the many types of actors that they could be involved as imple-
menters, the way they can work and collaborate, and the variations in their expertise,
knowledge and even the areas of interest within accessibility. They have a rather
illustrative and communicative value between economic modelling and evaluation than
a direct application and implementation to any measurable conditions and aspects.
The personas include functional elements (e.g. what the identified persona is doing
with the system) accompanied by a short application scenario for testing purposes.
Three potential generic personas and application scenarios are based on initial ideas
of the how main actors will interact with the system-in still a fragmented style- but
focusing mainly on the story about who the user of a particular technology is, what they
want, what they know.
Persona 1: Actor – Producer-Economics: GUI adaptation of route guidance system for
visually impaired users (Support independent living).
Simon is a developer (Actor -Producer – supply-end of chain) who has long been
working in making accessible applications for many years. He has worked in a large
company for many years and lately he is interested in navigation support systems for
marginalized user groups such as people with visual impairments. He found out about
the Prosperity4All multi-sided platform via blog for developers he often visits and
receives the Newsletter. When he visits the developer part of the platform he is unsure
about which component of the DeveloperSpace is more appropriate for what is looking
for to do. He checks the link and visits the Prosperity4All training platform. He selects
the curriculum for external implementers and specifically the course on adapting GUIs
for visually impaired users especially for navigation support software.
He then selects the component for changing the interface of the routing guidance
system and makes it available to the platform for users to buy. There is also an option
for the user to ask for a specific customization to be made and there is an opportunity to
hold a discussion with the developer prior the purchase.
Application of scenario for testing: The implementer will adapt the GUI interface of
the route guidance system for visually impaired users. Testing at early stages of
development will be performed together with other low or medium fidelity prototypes.
Persona 2: Actor – Producer-Law: Making accessible learning materials (Support
independent education and work).
Carla (Actor – Producer – supply end of chain) is a freelancer who is currently
collaborating with a large public library aiming to make their digital resources
accessible to blind and visually impaired users. She visits the Prosperity4All platform
and accesses the part for developers and implementers in order to find relevant
resources for her work. The training videos were very helpful and she found numerous
resources about different screen readers and their implementation to the vast and
diverse digital books and information available. The workload is huge but still the
resources and tools available at the Prosperity4All platform will assist Carla by
saving-time looking for methods and tools in the internet and increasing her potential
and knowledge in the accessibility domain.
Application of scenario for testing: The implementer will select a tool to enhance
the accessibility of digital documents to be accessible by blind and visually impaired
users (e.g. either one or two screen readers). Testing at early stages of development will
be performed together with other low or medium fidelity prototypes.
Persona 3: Actor – Producer-Ethics: Adaptation of Assistance on Demand
(AoD) services for older people (Support inclusion of lower or no literacy computer
users).
Nick (Actor-Producer-supply end of chain) is working as a developer and IT
specialist in a national bank branch. He is also a volunteer at the regional Elderly
Centre near his home. He is deeply concerned about older people and their lower digital
literacy. He is helping them to learn how to use computers. He wants to find a way to
help older visitors use the website of the elderly center. He is teaming up with a friend
who is actually working as social worker at the center and is pretty aware of the
problems older computer users might face and he is just an enthusiast (i.e. he is an
amateur software designer). A friend informed him about the Prosperity4All platform
and the availability of the AOD framework for enhancing the existing AOD set up of
the service provided by the Elderly Centre in order to provide appropriate and adequate
technical support to lower digital literacy older users. Their work aims to increase
independent use of computers by the users.
Application of scenario for testing: The implementer will use the AoD infrastruc-
ture to enhance the AoD services and make them more accessible. Testing at early
stages of development will be with other low or medium fidelity prototypes.
2.2 Tools, Resources and Products

The DeveloperSpace repository includes the tools and any relevant additional docu-
mentation (e.g. instructions, manuals, etc.). At the very early stages of the project,
many of these tools and resources are available as prototypes, mock ups or even as a
proof-of-concept. While most of the applications and services have been evaluated
already within the scope of other projects, enhancing them is “another story to be told”.
These tools will be used to make accessible or improve the existing accessibility of
different products and services, covering needs from many areas of daily activities
(such as communication, education, health, and employment).
The tools and resources used by implementers fall in to the following three main
categories and will be:
• Web-based Developer Resources and Assistance on Demand (AoD) services.
• Tools and Frameworks with Graphical User Interfaces for Development (IDEs).
• Building Blocks and Frameworks (with no graphical interfaces) for developers
(API).
Those three categories are driven by both the categories of different outcomes (com-
ponents, tools, services, and infrastructure) and practical considerations and needs for
testing and evaluation. Both outcomes and implementations can belong to multiple
categories. The implementers will use tools from these categories to improve, enhance
and add new functionalities to more than ten existing products falling into the fol-
lowing three main types:
• Communication, Daily Living, Health, and Accessible Mobility.
• Education, eLearning, Business and Employment.
• Assistance on Demand (AoD) Services.
One important consideration was made within the evaluation framework and that was
to evaluate the specific effect of Prosperity4Aall as much as possible. While most of the
applications and services were evaluated already in the scope of other projects,
enhancing them is “another story to be told”. It is very important that human factor
evaluation also focusses on the unique prosperity propositions that come through the
project and the exposure of the tools within an ecosystem. Therefore it is important to
understand that all interactions between developers and implementers are made through
exactly that evolving ecosystem. Evaluation will be carried out for both the Devel-
operSpace (where all tools will be available) and the use tools, resources and appli-
cations (internal and external) in the context of the DeveloperSpace.
Particularly for the infrastructure of the DeveloperSpace, the project will develop
multiple developer-facing components that are exposed to implementers (there is also
user facing components exposed to end-users that are not part of the testing methods).
Many of those outcomes will be presented as web-based developer resources. Most
prominent example is the component listing (repository) that will be a directly visible
outcome. In those cases, proven user experience methodology can be applied. The user
model of a developer is different from an end-user in the domain, however, particularly
here transition between roles need to be considered for certain stakeholder classes (for
user-programmers).
Particularly for the first and second category of tools, the matchmaking aspect is
becoming of further importance. While many of the web-based resources will be an
entry-point for many types of stakeholders, the picture differentiates quickly after that.
Particularly there will be “no-one-fits-all” usability for components. The goal of
Prosperity4All is to enable the selection of fitting components and furthermore the
fitness of the components for relevant stakeholders, which differ for component to
component.
Because often it is not easy to get a summative picture regarding components,
services and tools and implementations there will be a two stage process. The first stage
will be a match-making inside the project via the DeveloperSpace. This matchmaking
already takes the usability of the web resources into account. After this initial
match-making, the hypothesis is built that the selected implementation should be fitted
to the implementer that selected it. In the second step we are particularly evaluating the
usability based on this assumption and use the evaluation also as a formative tool to
improve the tools to become better. For those evaluations, established human factor
evaluation techniques can be partially applied; particularly if a tool exposes a graphical
interface to the developer.
The following high level objectives will be measured:
• Strengths and weakness of used tools and resources.
• Cost-efficiency perceived measures (e.g. considering time and effort compared to
current practices; consideration for experience in accessibility is important)
• Improved user experience.
• Utility, usefulness and learnability.
• Acceptance compared to current practice.
• Matching of notation and graphical elements regarding relevant user and devel-
opment activities.
• Freeing of developer to concentrate on creative aspects of the process.
• Global developer experience with focus on perceived attractiveness (for
developer-facing tools and efficiency of offered and available tools and resources).
• Matching of offered tools and resources to needs and requirements.
• Decision making process and changes to it.
• Knowledge and experience driven attitude and productivity.
• Willingness to use and apply in future.
They are high categories which are stratified further into simpler constructs and will be
matched to further methods and indicators during the lifetime of the project.
2.3 Conditions and Techniques

Testing with implementers will be primarily carried out in three contexts: (a) in their
own work environment with real use of components and tools (group assessment, i.e.
peer heuristics), (b) remote testing (remote data gathering), and (c) face-to-face qual-
itative assessment. Considerable part of testing will be carried out in their own
environment gathering mostly qualitative data. Focus groups will be carried out with
implementers in small groups (5–8 participants) which could be organized in parallel
with demo workshops. The focus groups will provide enriching data to the interviews
held with participants and the rest of collected data. This is relevant to data triangu-
lation and filling the “gaps” of other methods of data acquisition.
Conditions will vary between phases and among users. Each user might implement
different outcomes for making an application or service accessible. During the first
phase, implementation will be in some cases emulated as non-functional versions of
tools might only be available (e.g. mock ups, paper prototypes). Another sample of
implementers should be anticipated for the impact assessment. They will probably
remotely assess the Prosperity4All ecosystem as part of impact assessment. These users
will freely interact with the platform and evaluation will involve a real-life assessment
of the ecosystem.
The conditions of testing are based on application scenarios which will serve the
requirements of the evaluation framework.
Apart from traditional testing aspects, there are therefore two key features con-
sidered in the evaluation framework: (a) matchmaking – how tools fit the process and
applications, (b) cost-effectiveness - of the use of specific tools in order to reveal how
implementers are driven to choice of tool(s) (i.e. elaboration on decision process in
relation to reference case). For the later multi-criteria analysis will be used for certain
number of implementers. Tests with the applications and services will investigate the
applicability and usefulness of the technology infrastructure. Most of the implemen-
tations are applications and services already offered to consumers and therefore they
will not be evaluated per se. On the contrary, many of the tools and the DeveloperSpace
will be developed within the project and therefore many of them will be offered as
prototypes, mock ups or even proof-of-concept at the very early stages of the project.
3 Conclusion
The user model of a developer is different from an end-user in the domain, however,
particularly in this case transition between roles needs to be considered for certain
stakeholder classes (for user-programmers). This work will provide an understanding
of implementer’s experience. Developers and implementers usually are on the
receiving end of the evaluation process (i.e. receiving feedback) but in this case they
will be actively communicating their experience with certain tools and products.
In a world of increasing ICT expertise, and greater future overlap among profes-
sional disciplines, the boundaries between users and developers are expected to become
difficult to draw and balanced knowledge of both ends is of core importance for valid
and reliable inferences.
Acknowledgments. This paper presents work carried out in Prosperity4All project. This project
has received funding from the European Union’s Seventh Framework Programme for research,
technological development and demonstration under grant agreement no. 610510. http://www.
prosperity4all.eu/
References
1. Blackwell, A.F., Green, T.R.G.: A cognitive dimensions questionnaire optimised for users. In:
Proceedings of the Twelfth Annual Meeting of the Psychology of Programming Interest
Group (2000)
2. Green, T.R.G.: Cognitive dimensions of notations. In: Sutcliffe, A., Macaulay, L. (eds.)
People and Computers V, pp. 443–460. Cambridge University Press, Cambridge (1989)
The Study of Using Facebook in Taiwan’s
Elderly Population—a Case Study in Learners
of the Senior Citizens Academy in a City
of Taiwan
Ming-Wei Wang1(&) and Yu-Chin Lin2(&)

1
Senior Citizens Academy Lecturer in Chiayi, Chiayi, Taiwan, ROC
[email protected]
2
Director of Home-Service Management Center, Chiayi Christian Hospital,
Chiayi, Taiwan, ROC
[email protected]
Abstract. Mark Zuckerberg founded Facebook site in 2004, and open to e-mail
applications use in 2006. The global active users of the Facebook site surpassed
one billion people on September 14th, 2012. It spent 13 years that the users of
the Google site founded in 1998 surpassed one billion people in 2011. It spent 8
years that the Facebook site to do so. The official statistics of the Facebook site
represented that there are about 15 million users visited the Facebook
site monthly and there are about 12 million people visited the site by using the
mobile Internet devices in the fourth quarter of 2013 in Taiwan. In the same
time, there are about 11 million users visited the Facebook site daily and
there are about 8.5 million people visited the site by using the mobile Internet
devices in Taiwan. Taiwan is a mature market for the Facebook site, the website
penetration is the highest in the world.
Taiwan in where the Facebook site utility rate is so high faces the rapidly aging
population issue. According to the statistics from Ministry of the Interior,
Republic of China, the ratio of the population over 65 years old has exceeded 7 %
in 1993. It means that Taiwan is the aging society. The ratio of the population over
65 years old is 11.90 % in October, 2014. With the statistics from Council for
Economic Planning and Development in the Republic of China Executive Yuan,
the ratio of Taiwan elderly population will exceed 14 % in 2018, and Taiwan will
be the aged society. The ratio of Taiwan elderly population will increase quickly
from 2014 to 2025 because of the effect of the postwar baby boom.
This investigation using action research discusses the elderly people studying
IT lessons in the Senior Citizens Academy of a city in Taiwan. How do they use
the Facebook site? We found that the elderly people is not the main usage group
of the Facebook site, but using the Facebook site impacts positively for their
learning, social networking, and the interactions among their family members.
There are two difficulties for elderly people to use the Facebook site, one reason
is they are not used to share their thinking to others, and the other reason is the
computer operation is difficult for them. We also found that some of the elderly
people begin to use the mobile Internet devices what are new things for them,
and they use the internet, the Facebook site, Line by making use of the mobile
Internet devices.

DOI: 10.1007/978-3-319-20892-3_39
The Study of Using Facebook in Taiwan’s Elderly Population 399
1 Introduction
The author served as the Senior Citizens Academy lecturer since 2008, and the main
teaching subject is computer and internet using. Most of the students are over 65 years
old. According to the author’s observation, they face the serious digital divide. The
reason is the city they lived is a small city in Taiwan (The city area of 60.0256 square
kilometers is the smallest city in the Taiwan Island.), most of the students’ sons and
daughters live and work in the other big cities such as Taipei, Taichung and Kaohsiung.
The students don’t have the opportunities to live with their sons and daughters, so they
can’t exchange of new knowledge with their families. They lack the opportunities to
learn something new, their lifestyle cannot keep up with the Internet era, and their
source of information is still television programs, newspapers or magazines.
In March 2008, the Senior Citizens Academy first ran computer courses in the city
that the study refers to. When the senior citizens found that they have the opportunities
to learn the computer technology and the internet, they found the focus of life, and the
focus is to learn something new from the internet. They watch videos or listen music
from YouTube, read news from Yahoo news, and contact others with emails. In recent
years, Facebook users have a substantial increase. In order to catch up with the trend of
the times, they started to learn how to use Facebook, to share their recent life with
others and observe others’ life. They found that they can see almost everything they
want on the computer screen.
As the lecturer of trainees, we want to find how they use the Facebook? Do they
have any difficult on using Facebook or computer? Is the interface of computer using or
Facebook using friendly to the senior citizens? What teaching methods are suitable for
the elderly to learn computer and internet using? This is the motivation for the study.
2 Literature Review
How can we define that people become to old? We will discuss the thing in four aspects
(Huang 2007):
First, the point of real ages. Every country defines elderly people in different ages.
In China, Russia and France, people over sixty years old are elderly. In America,
England, Italy and Canada, people over sixty-five years old are elderly. In Taiwan, the
government formulated the law of Senior Citizens Welfare Act. We define that people
over sixty-five years old are elderly.
Second, the point of biological ages. When the individual organs reach maturity,
they will begin to lose its proper function. There are four indicators:
1. The loss of reproductive capacity: The menopause occurrence is about fifty years
old before or after for female. There are generally no obvious signs for male.
2. Grayed hair: What is the age for people’s hair being gray? There is considerable
variation between individuals, but the appearance is most likely to be considered to
be an important feature of the elderly.
400 M.-W. Wang and Y.-C. Lin
3. Physiological dysfunction: including audiovisual capabilities recession, shortness of

breath, reduced lung capacity, decreased muscle elasticity, balance diminished
capacity, inadequate stamina. The changes are the individual’s self-perception and
the impacting on the individual’s self-identify. They will make individuals to define
themselves becoming old.
4. Chronic generation: The chronic is the disease of unknown causes, no way to cure,
controlling symptoms by drugs, such as hypertension, diabetes, arthritis, etc. When
individuals suffer from the chronic diseases, and the diseases become a part of life,
we think the individuals grow old.
Third, the point of psychology. This is the age of the individual at the psycho-
logically subjective feelings. These feelings come from social and psychological fac-
tors. The social factors include that the children growing up and getting away from
home, the birth of grandsons, the death of the spouse, the forgetfulness on the everyday
life, the loss of the patience and so on. The psychological factors include that the loss of
the thinking ability, memory loss, inability to concentrate, lack of capacity to solve
problems and so on.
Fourth, the point of socialization. The social status of an individual or a particular
behavior occurring will be treated as the individual development indicators. Individual
aging indicators often consist of the following three:
1. Retirement: It means the individual don’t work for full time or work for pay. His
income is a pension. The retirement is generally considered an important of the
elderly.
2. Becoming grandparents: The age to be grandparents was about fifty years old.
Because of the change of social pattern, the general situation of late marriage, the
age to be grandparents is older than before.
3. The parents loss: When the individual lose parents, he become the oldest generation
in the family. The situation means the individual become old.
The most significant characteristics of the elderly are aging, followed by forgetting
(Zhan 1991). The physical and psychological aging can be attributed to the natural
laws, but how much time is the old age depends on the length of life. Some people live
longer because they have a long old age, and some people die when they are not old
because of various factors. Forgetfulness is another feature of the elderly. They often
forget things around, but they remember for the last things very clearly. When a person
regular wallows in the past things, maybe he is old.
The above references tell us that the meanings of old have different standards
including age, physiology, psychology and social perception. The aspects of old
contain subjective awareness more or less or the standards of old are different.
Therefore, the definition of age as old is the most common definition and the definition
is based on the laws.
The professionals for educating and serving the elderly adopt for four different
thinking (Moody 1976).
1. Denial mode: The elderly population created limited economic value, so the elderly
education is uneconomic. This idea does not meet the viewpoint of modern edu-
cation, and the elderly population also has the right to continue learning. This idea is
inconsistent with modern society.
2. Social serving mode: The problems caused by the increasing in the elderly popu-
lation can be improved through changes in public policy. The observation
emphasizes social justice and equality and does not research the problems that the
elderly face and solve them. The elderly take the serves passively and do not face
the life by enhancing their abilities. This viewpoint is derogatory (Long 1986).
3. Active mode: This viewpoint is certainly worth the elderly population because of
their abilities, experience and living skills. The elderly can help our society to face
some problems. Therefore, the elderly education can encourage and help them to
participate in our society, to prepare reemployment, or to be volunteers.
4. Self-realization mode: This viewpoint extends from the active mode. It emphasizes
that the educational activities enhance the spiritual growth. Moody said that the
important feature of the elderly population is to seek the purpose of life from spirit
level. Bramwell (1992) said that elderly education should focus on self-fulfillment,
self-realization, self-growth and self-transcendence. Walker (1996) said that the
final purpose of the elderly education is self-realization.
From the above literature, we find that helping the elderly to enhance their
knowledge and ability to adapt to the ever-changing society is a part of the purpose of
elderly education. The self-realization and the advancement of social status are
important in the elderly education, too.
Until Dec. 2014, the population is 270,883 people in this small city in Taiwan, and
the elderly (over 65 years old) is 33,336 people, over 12 % of the city population. The
elderly is 2,808,690 people in Taiwan, accounting for 11.99 % of the country’s total
population. Establishment of ageing-friendly environment will be an important gov-
ernment policy.
For elderly computer users, unfriendly user interface (too much words, too small
word, etc.) often causes trouble on the use of internet (Hui-Ming Guo et al. 2007). The
scholars had pointed out that the reasons that the elderly refuse to learn new technology
are the complex operation flow and unfriendly user interface (Zhao et al. 2009).
3 Research Methods
Action Research is a process of self-reflection inquiry in the social or educational con-

text. Participants included teachers, students, principals and others. The research aims at
rationality and justice of social or educational practices. It helps researchers to under-
stand the practical work, and makes works more efficiently (Carr and Kemmis 1986).
On the teaching part, Action Research is a research method for educational envi-
ronment. Its purpose is to understand the quality of teaching and looking for a better
way to teach (Hensen 1996). It includes the observation of the teaching process, finding
and solving the problems, and is a systematic and sequential method for research
(Dinkelman 1997).
According to Johnson’s book (A Short Guild to Action Research); he pointed out

ten characteristics about Action Research:
• Action research is a systematic researching method.
• The researchers have no any presumptions.
• It is not necessary to get the way of research complex.
• It needs detailed plans to collect data.
• The research is no time limit.
• Regular observation is necessary, but it is not necessary to spend a lot of time on
observation.
• The research process can be simple and informal, and it can be rigorous and formal,
too.
• Action Research requires theoretical foundation.
• Action Research is not a quantitative research.
• When the research result is quantitated, the application of the result will be limited.
The object of the study is 89 elderly students attending the computer courses in
the Senior Citizens Academy. The author is the course instructor, his jobs are teaching
the elderly students to use the internet, to read the messages on the screen, to input the
words (Traditional Chinese characters), etc.
4 Results
The computer courses are popular in the Senior Citizens Academy. We have to spend
more than 8 weeks (3 h in a week) to teach the students the basic operations. The basic
operations are turning on and off the computer, using the keyboard to input the words
in Traditional Chinese Characters, using the mouse to click the desktop icon on the
screen (to click the mouse left button twice quickly, this is the most hard operation
process in the beginning of the courses), browsing the internet, learning to find
something on the internet, etc.
When we start to teach the using of Facebook, it is difficult to teach the students to
sign up a new username. It’s too much data for them to input, and they have to write the
username and password in their notebook, or they will forget the words (Some stu-
dents’ memory is not as strong as the young men). We understand that the point of the
teaching is how to use Facebook, not to sign up, so we suggest that the instructor sign
up for the elderly students before class, and give the username and password to the
students in class. It will save o lot of time.
Taiwanese conservative personality makes the elderly students not used to share
their motions to others. They don’t understand why we share everything in Facebook.
They will not share their thinking in Facebook. First of all, we suggest them to be the
instructor’s Facebook friend. They will understand what they can share in Facebook,
just as the instructor share. And the next, we will suggest them to click
the < Like > button. They will understand how to interact with others in Facebook.
When they click the < Like > button, we will teach them how to leave a message in
others’ Facebook. They will input “Good!” or “Nice!”.
To share photos is a good begin in the Facebook using. But the elderly students
have to connect their camera and computer to download their photos to the computer’s
disk, and upload the photos to Facebook. The process is complex for them. We have to
review the process for them several times and maybe 10 to 20 percent of the elderly
will give up. It is necessary to encourage them to share their life in Facebook, and get
more Facebook friends, just like their sons, daughters and grandchildren. It will make
them be interested in using Facebook.
We will tell them how to share news or articles in Facebook. It is another way to
use their Facebook. Maybe they would not share their feeling or thinking in their
Facebook, but they like to share the articles to others, especially the content of the
articles is about health. It is important for them to be healthy.
A handful of the elderly like to share their life experience in their Facebook, and
this is our goal, to save their stories in Facebook. Typing is difficult for the elderly, and
the handwriting input devices are not convenient for them. For our elderly students, to
input words is always a trouble. How to improve the method of input is worthy of
study.
After we finish the class, less than 25 % of the elderly students keep using their
Facebook. To maintain the relationships with Facebook is maybe important for us, but
not important for them. They maintain their relationships in a dinner party or regular
meetings.
In the teaching process, we set up a bicycle team for the elderly students and set up
a Facebook page for the team. At first the idea is to encourage the elderly to exercise for
their healthy. We spent four days riding the bicycles to travel, and total distance is
220 km. We uploaded the photos taken in the activity to the Facebook page. The team
members took the initiative to find ways to download their photos in Facebook page. It
is the way to encourage the elderly to use Facebook.
In the observation, we found that when the elderly find something interesting or
relate to them in the internet, they would take the initiative to learn the knowledge
about the internet. Creating the goal is a good way to encourage the elderly to learn.
Due to the trend of the times, we set up the courses to teach the elderly students to
use MID (mobile internet devices). The elderly students would set their personal data in
their smartphone or tablet computer. When they use their MID, they don’t need to
input their username and password every time, and it is convenient for the elderly to
maintain their Facebook running.
5 Future Research Directions
According to the survey about Taiwan wireless internet use, the proportion of people in
Taiwan to use wireless internet access continue to increase. The internet applications
people use most often with mobile internet are using the internet community websites,
using instant messaging and visiting the websites (TWNIC 2015). We also found that
Line (instant messaging) is popular in the elderly. The software makes a new way to
communicate to others. The situation is suitable to be explained with Technology
Acceptance Model. When the elderly students find an App (application) that is useful
and using easily, they would like to learn the using and start to use it.
To keep one’s Facebook running with desktop computer is maybe difficult for the
elderly, but to do the same thing with MID is maybe easy for them. On the other hand,
maybe Facebook is not their need. They are not used to share something in words.
When they need to share some photos, they use the instant messaging just as Line. The
interface of Line is simpler than Facebook.
On the point of Perceived ease of use, which one is easier to use for the elderly?
Desktop computers or MID? When they don’t need to type, the handwriting on MID is
useful for them. To observe on their usage of MID is the next step for us to research.
What kind of interface on MID is the elderly need? It is the future research directions.
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An Older Person and New Media in Public
Discourses: Impossible Encounters?
Monika Wilińska(&)
Sociology, Social Policy and Criminology,

University of Stirling, Stirling, Scotland, UK
[email protected]
Abstract. The aim of this paper is to consider the use and role of new media in
the lives of older people. To this end, I focus on the social images of encounters
between older people and new media. My focus is two-fold; on the one hand, I
aim at opening the academic discussion on new media and older people to
societal and structural considerations; on the other, I make an argument about
the use of discourse, critical discourse analysis in particular, approaches to
understand the main discourses that frame the experience of older people with
new media. Thus, in this paper I question taken for granted assumptions
regarding the inherent characteristics of older people that prevent them from
entering the social media space. I draw on the concept of ageism to discuss the
implications of this for an individual, older social media user.
Keywords: New media Older person Discourse Social imaginaries
1 Introduction
The main argument of this paper is that the use of social media by older people needs to
be understood in the context of societal discourses about the encounters between an
older person and new media. The societal discourse of old age is understood to have
overarching implications on both the personal and social experience of ageing [1–3].
The social dimension of ageing determines roles assigned to older people in a given
society. Thus, age is regarded as one part of a social stratification system; it encom-
passes suppositions related to the appropriateness of certain social positions, which
affect the behavior of a person or a group [4].
The socially constructed processes of ageing and old age are however materialized
in the everyday choices and decisions made by, for, and on behalf of older people. In
this, many activities and forms of behavior are coded [5] as either more or less
appropriate for people who have entered the socially defined period of old age. The
problem with these coding practices is that they often become naturalized and accepted
as the expression of what is called ‘the norm’. This is particularly visible at the level of
language use. For example, a saying ‘mutton dressed a lamb’ is rarely questioned as
inappropriate and derogatory to a person who is described in this way. Ageism is the
main reason for this.

DOI: 10.1007/978-3-319-20892-3_40
406 M. Wilińska
1.1 Ageism
The term ‘ageism’ refers to discrimination based on chronological age [6]. The term
was coined in 1969 by Robert Butler, who stressed that this type of prejudice and
discrimination refers to any age group, though old people are at the highest risk of
being affected [7]. This “last form of discrimination” [7, p. 3], preceded by sexism and
racism comprises the variety of negative attitudes towards old people. The ageing
process is viewed as something that renders people unattractive, unintelligent, asexual,
unemployable and mentally incompetent [4]. However, the phenomenon of ageism
needs to be understood as much more than a set of attitudes because ageism “is also a
complex tendency woven into the social fabric” [8, 9] that is built on age relations [10]
and intersecting relationships of inequality [11].
Ageism operates at different levels, including the personal, interpersonal and
structural domains of human life [12]. Its prevalence is so profound that some question
even the possibility of thinking about non-ageist societies (see [13]). Ageism is a form
of social oppression that produces a fear of the ageing process and uses age as a
signifier of classes of people [6]. Ageism is manifested through a number of processes,
including systematic stereotyping, discrimination and the reinforcement of divisions
between ‘us’ (the young) and ‘them’ (the old) that are founded on the assumption of
homogeneity among old people [6, 14].
Ageism is enacted in social relationships and attitudes, and it always has negative
connotations, unlike age discrimination, which may have both positive and negative
characteristics [7, 15, 16]. Ageism, as a form of social practice, always refers to the
aged body, and there are many arenas in which ageism operates [17]. These include
relationships in the labour market, welfare policies and culture [17]. Culture remains
one of the major sites of ageist practices that sustain “decline ideologies” [18], which
tend to reduce the experience of ageing and old age to the sense of loss, despair due to
being ‘defeated’ by passing time.
A wide range of empirical investigations of ageism discusses its various enactments
in popular culture. From birthday cards [19] to TV programs [20], newspapers and
magazines [21, 22], marketing strategies [23–25], and the food and cosmetics indus-
tries [26, 27], we learn about various prejudices against ageing and old people. These
studies tend to focus on linguistics practices in either talk or text to emphasize the
extent to which ageist assumptions and practices find their way into everyday lives.
Language remains one of the key mediators of ageism.
1.2 New Media and Ageing

According to the report published by Pew Internet Project (2013), the use of social
networking sites (SNS) among 65+ Internet users increased from 13 % in 2005 to 43 %
in 2013. These changes go hand in hand with increasing number of studies that
examine the use of social networking sites among older people. Studies investigating
older people’s engagement with this type of media tend to look at reasons and expe-
riences of using it (e.g. [28–30] as well as non-users views on why they prefer not to
engage with social media (e.g. [31, 32] to recommend changes: (a) in design of social
An Older Person and New Media in Public Discourses: Impossible Encounters? 407
networking sites to make it more age friendly, and (b) in the perceptions of older people
regarding SNS.
Those studies point at experiences of uneasiness, fear, and embarrassment about the
use of SNS as common among older people. In an overview of literature that examines
the interaction of older people with SNS [33] conclude that concerns regarding privacy
and unsuitability of current SNS designs are found to be the key factors that prevent
older people from engaging with this type of media. These findings need to be however
seen in context.
This paper draws attention to the fact that how older people engage with SNS is not
only related to their personal characteristics and technical features of SNS design. To
understand these encounters and their lack, we need to understand how societal dis-
courses envision such meetings and how the use of SNS is coded in relation to age.
Further to that, debates regarding the use of new media in general and SNS in particular
tend to be based on representations of older people as a specific group of users/non-users
who require a special attention. Although the main reason for that is a genuine concern,
the reality is that such representation may lead to static and essentialist understandings
of old age that not only reduce old age to a disadvantageous condition but also propagate
the image of older people as a homogenous group [14], preventing us in this way from
seeing an individual with her/his unique life history.
2 Discourse
Discourse is understood as a symbolic system and social order [34] that is composed of
“meaningful practices that form the identities of subjects and objects” [35, pp. 3–4].
Everything we do has some meaning that is relevant for our way of living. In other
words, “discourses have implications for what we can do and what we should do” [36,
p. 75], and whom we can become. For example, the discourse of ageism is created at
the axes of many different practices, such as the use of discriminatory language, the
production of anti-ageing face creams, and the building of age-segregated housing, to
mention just a few examples. These are ready-to-go practices that show what to do to fit
in and to be included. In addition, institutions and social relations take part in (re)
producing certain discourses and are shaped by them. The discourse of ageism pro-
duces a divide between old-bad and young-good, which affects the ways in which old
people and young people interact.
Discourses embody rules, principles, and values that, at a particular point in time
and in a particular place, are crucial for the construction of social reality. These aspects
of discourses are considered as normal, natural and standard. The concept of discourse
allows us to understand, for example, not only why people spend money on anti-ageing
treatments but also why elder abuse tends to be seen as less dangerous than other forms
of abuse. The discourse of ageism constructs ageing as worthless and hazardous to
people. It also explains the attempts to build segregated living areas for old people, and
it sheds new light on active and positive ageing policies. These examples also highlight
that discourses have real-life and material consequences.
408 M. Wilińska
2.1 Critical Discourse Analysis

The origin of critical discourse analysis (CDA) can be traced back to early 70s, when a
group of British researchers initiated studies of relations existing between language,
power and ideologies [37]. The concept of power and ideology lies at the core of CDA
and their embodiment in discourse is used to explain life of societies, their members
and cultures [38, 39]. Thus, CDA warrants the process of consciousness-raising,
revealing, reflecting and transforming persistent in the societies inequalities and dis-
criminations induced by the above [40]. Media discourse occupies the prime position
within this tradition by the dint of its role in expressing, constructing and reconstructing
power relations that are accustomed in the society. Its overarching scope encompasses
assertions concerning representations, identities and relations among discussed groups
of people and phenomena [41].
CDA emerges as a valuable framework when investigating the relationships
between language, power and inequalities. Language is an indispensable part of
society, in the sense that linguistic phenomena are social and vice versa [42]. The use
of language is, hence, considered to be constitutive of social identities, social relations
and systems of knowledge. CDA focuses on revealing how language-in-use constitutes
unequal power relationships, contributes to injustice and perpetrates discrimination; at
the same time, it offers insight into particularities of social change through language
use. Importantly, CDA attends to the ways in which some people are given the vice
while others are either silenced or neglected to discuss issues of social change.
3 An Older Person(s) and Social Networking Sites
In this section, I will consider several examples of cultural texts that touch upon the use
of SNS by older people. Using the perspective of critical discourses analysis, I will
discuss those examples within the context of ageist assumptions that pervade our
societies. Ultimately, this section will demonstrate that even positively sounding
messages, such as: “Social networking sites for older people are wonderful ways to
meet and share information with like-minded people. Social networking isn’t just for
youngsters; there are many sites suitable for older people on a wide range of subjects”
(http://socialnetworking.lovetoknow.com/Social_Networking_Site_for_Older_People)
perpetuate ageism and contribute to the creation of an imaginary divide between
different age groups.
3.1 ‘Groupism’
“Nearly two-thirds of people aged 50–64 are on Facebook, which could explain why
many younger people are switching to Twitter. But many older people haven’t grasped
the lingo, misusing terms like LOL, believing it to mean ‘lots of love’ rather than
‘laugh out loud.’”(Daily News, August 6, 2013).
“Although it [increasing number of older people using social media] may be bad
news for younger people who don’t want their parents snooping or uploading
embarrassing baby photos, it’s great news for marketers. (…) The key is to treat older
media users just like any other consumer – though it might be worth teaching your
mum what “lol” really means.” (http://www.candidsky.com/blog/social-media-and-the-
older-generation/).
Articles like the above are exemplary in demonstrating the way older people and
their encounters with social media are presented in public sphere. The key appears to be
the imaginary war between ‘the young’ and ‘the old’ that is presented as a natural
feature of intergenerational relations. The ageist assumption that underlines such
images leads the authors of the first quote to conclude that as older people increase their
use of Facebook, younger people lost interest in it as the site becomes associated with
old age. In this way, we are indirectly presented with an image of virtual space as
‘naturally’ age-segregated, which does not encourage relations across generations, but
is rather bound by strictly defined rules regarding who is ‘in’ and who is ‘out’. Once the
outsiders manage to enter a given space, those who are ‘naturally’ found are quickly
promoted to look for and to create a different space that will again stave off the
presence of outsiders for some time.
In the second quote, the same assumption regarding the intergenerational war is
expressed in the envisioned embarrassment of younger people over, what is considered,
a typical behavior of older people. According to this image, older people are apparently
motived to use social media for two reasons: either monitoring their children or
extending their family life onto online spheres. Older people are therefore constructed
as unusual users of social media, who are above all else, different than the ‘natural’
social media users-younger people. This quote goes however further than this; it uses a
familiar family frame to strengthen the divide between different generations. By jux-
taposing parents to their children who in our culture are always presented as two binary
groups, the second quote applies a family frame to present relations between SNS users
of different ages. Indirectly, the link between children and the future versus parents and
the past is brought to the forefront. Therefore, older people using SNS are constructed
as being out of space and having little if any understanding of the rules of the game.
Interestingly, both quotes use the same phrase “lol” to illustrate the incompatibility of
older people and new media. Language is used to both describe this unfit and to give
evidence. In this, both examples reproduce the academic discourse on ‘digital immi-
grants and natives’ [43] who speak different languages.
The difference between two quotes is that although both are based on ageist
assumptions, the second one finishes on a lightly more positive note. Clearly speaking
from the perspective of adult children, the authors encourage their peers to teach older
people (read: older parents) how to use and understand the language of SNS. This may
appear as an anti-ageist gesture. However, as Hendricks [8, p. 5]warns, this form of
“benign or compassionate ageism, sometimes labeled the “poor dear” syndrome, is no
less dehumanizing than its negative counterpart - either way people are viewed through
a stereotypic lens”. In a similar vein, slogans, such as “Older adults warm up to social
networking” (http://www.techhive.com/article/2045964/older-adults-warm-up-to-social-
networking.html) and “Old School, Meet New School: Seniors Tackle Social Networks”
(http://www.cnbc.com/id/100537483#) may at first appear as rather positive. However,
they too are based on an image of older people as distinctive ‘they’ who are different
from the regular, if not ‘normal’ users. Thus, the encounter between SNS and old age
seem to result in a form of ‘groupism’ that characterizes all older people as the same,
410 M. Wilińska
and portrays them as lacking knowledge and skills that are needed to effectively engage
with this new type of media.
3.2 It is All in the Family

Mentioned above the family frame used to explain differences and relationships
between various age groups of SNS users is commonly used to emphasize not only the
specific characteristics of older people as SNS users but also to explain what motives
older people to use SNS. The below quote from a blog post entitled: “Why Your
Grandmother Should Use Social Media” is an example:
“Your grandkids will think you are the coolest grandma or grandpa around because
you are Internet savvy!” (http://blogs.wsj.com/experts/2014/12/03/why-your-grand
mother-should-use-social-media/).
Building on family relationships, this quote introduces older SNS users as grand-
parents. This has far reaching consequences for creating images of how and why older
people should use SNS. Contrary to earlier mentioned examples, the one discussed here
implies even a bigger distance between two groups of users that are separated by one
generation. The image of grandchildren and grandparents is often used to idealise the
family relationships and intergenerational solidarity. Particularly, ‘the perfect grandma’
stereotype is effectively used to create an image of older women as entirely focused on
family lives and devoted to their grandchildren [44]. This is a stereotype that combines
ageist and sexist assumptions about the role of older women in societies to imply which
activities and spheres of life are more natural to them and which are not [45]. Seen
through the family lenses, older people as grandparents are thus imagined to live for
their grandchildren and use their appreciation to build self-confidences and positive
images of themselves. In this way, social media is presented as a natural habitat of
younger people-grandchildren, and older people-grandparents are encouraged to enter
that sphere to get closer to their family members. Importantly, the whole image is often
built on the ideas of inherent incompatibility between older people and social media-
this is further emphasized by pointing out that those who use it are exceptional and
therefore, named as “coolest” by their grandchildren.
3.3 Social Problem

In October 2013, the British Health Secretary Jeremy Hunt in one of his speeches
defined the problem of loneliness among older people as “national shame” [46]. This
speech triggered many discussions in the UK particularly that families were to bear
greater responsibility for ensuring that their older family members will not be lonely. In
May 2014, a think-tank Policy Exchange announced a report which stated that increase
in the use of internet among older people could reduce loneliness in old age [47].
Independent Age, a charity organization that offers advice and support to older
people in the UK and Ireland aims to combat three forms of poverty among older
people: financial, social and information. Within this context, defining its problem
areas, it points to the figure of 5.3. mln people aged 65+ as those who “have never been
online” (http://www.independentage.org/about-us/). In this, the use of online resources

or rather lack of it appears to be as alarming as living below the poverty rate or
suffering from fuel poverty.
The above helps to explain messages, such as “Get the Silver Surfers on Facebook:
Experts say using social media can help prevent decline in elderly’s health (http://www.
dailymail.co.uk/news/article-2873604/Older-people-use-Facebook-social-media-prevent-
decline-health-study-finds.html#ixzz3LxmkiAPN). Increasingly, the use of SNS among
older people is presented as a health issue and a social problem. In her constructionist
account of social problems, Loseke [46] discusses two concepts that aid our under-
standing of how social problems are constructed: (a) social problem work - an activity of
categorizing something and/or someone as a problem; (b) social problems game – an
activity focused on convincing everyone about the seriousness, severity of a given
condition or groups of people. The rhetoric that begins to unfold in policy and media
discourse is indicative of the process of constructing the problem of older people not
using social media. In this, many actors are involved in categorizing the lack of use of
social media by older people as something that we need to be concerned with. Conse-
quently, we are convinced that poor use of social media among older people is directly
linked to loneliness and ill-health. As with any other social problem, one of its key
characteristics is the assumption that things can be changed [46]. In this case, it is older
people who are to change to solve their problems. There is an underlying assumption that
moving online will automatically make older people happy, healthy and it will enable
them to live to their full potential.
4 Concluding Remarks
The main tenet of this paper is that to understand an older person and his/her ways of
engagement with social media, we need to attend to societal discourses that frame and
define these types of activities. Only upon understanding social and cultural context in
which an older person may or may not interact with social media, can we discuss the
role of social media in everyday lives of older people.
Drawing on the concept of discourse and critical discourse analysis, this paper
identified several ageist practices that pervade our thinking about encounters between an
older person and social media. Continually, older people are referred to as a homoge-
nous group, they are often presented in their family roles and in general, and their low
level of engagement with social media is represented as a social problem to deal with.
Against this picture, the SNS activity in itself is coded as one most appropriate for young
people; older people are seen as unusual if not say ‘unnatural’ users.
This study is neither disputing the usefulness of social media nor claiming that
access to social media is easy and straightforward. Instead, the purpose of this paper is
to draw attention to the way in which SNS and older people became appropriated as
representing and belonging to opposing poles. This, as Loos [47] demonstrates, leads to
a number of misconceptions and myths surrounding the use of social media by older
people. In line with this, the paper at hand posits that discourses that remove an
individual replacing him/her with a group identity tend to be inaccurate, discriminatory,
and decontextualized. Thus, it becomes essential to question the images of older people
412 M. Wilińska
(not) using SNS and invest in contextualizing the discussion. This however, as Loos
[47] argues, requires not only shifting our thinking from ‘digital gap’ metaphors to
those of ‘digital landscapes’, but recognizing that how and when we access new media
is dependent on a variety of factors among which age is only one.
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Technology Generation and Media
Usage in B-2-B Communication:
A Cross-Cultural View
Martina Ziefle1(&), Vanessa Cabral2, Judith Leckebusch1,

and Toni Drescher3
1
Human-Computer Interaction Center, Campus-Boulevard 57,
52074 Aachen, Germany
{ziefle,leckebusch}@comm.rwth-aachen.de
2
KEX Knowledge Exchange AG, Campus Boulevard 55,
3
Fraunhofer Institute for Production Technology, Steinbachstraße 17,
Abstract. In this work culture-specific and cross-cultural influences on

frequency of use of media and trust in media for B-2-B communication purposes
were explored, taking Brazil and Germany as exemplary countries. Using an
online survey, 236 respondents from Brazil and Germany were examined
regarding their professional media usage. Findings show both culture-specific as
well as cultural insensitive media usage in B-2-B communication. Brazilians use
new media more frequently than Germans. However, it was also revealed that
cross-cultural variables as age, gender and technical self-efficacy influence even
more significantly the frequency of use of media. Furthermore, trust in media for
B-2-B communication showed to positively correlated with the frequency of use
of media in both countries.
Keywords: Business-to-business B-2-B New media Social media

Culture Age
1 Introduction
Due to new technology developments, enterprises from all over the world have been
facing the challenge of rebalancing between traditional and new media so as to effec-
tively conduct local and global business-to-business (B-2-B) communication [1, 2].
From the perspective of Social, Media and Communication Sciences, this phenomenon
is not only challenges regarding the question of which media and communication means
might be appropriate and accepted for different professional areas and communication
needs, more so, cultural identity and forms in social media usage in professional areas
are not adequately considered so far.
The modern world is highly interconnected through information and communica-
tion technologies [3, 4]. New forms of electronic media keep constantly reshaping the
ways of communicating all over the globe and in all areas of human interaction. In the

DOI: 10.1007/978-3-319-20892-3_41
Technology Generation and Media Usage in B-2-B Communication 415
so-called global information society [5], the integration of new media in corporate
settings is already a reality, following the enormous success of these new communi-
cation forms in the private sphere [6, 7]. For the business-to-business (B-2-B) com-
munication field, which concerns enterprise communication to and among internal and
external stakeholders, such changes have demanded a challenging process of rebal-
ancing between traditional and new media [8]. Yet, there is still a considerable need for
research in this area.
International B-2-B communication is on the rise, since cross-border transactions
have become significantly more intense over the past 20 years [9, 10]. In spite of
B-2-B’s essential importance for the global economy, most of the actual reports and
studies address primarily business-to-customer (B-2-C) communication issues, which
are often not pertinent in B-2-B settings [11]. Besides, most trend studies and surveys
on these topics provide findings that target mainly advertising and market aspects
[12, 13], leaving aside the complexity of media usage or media effects patterns. Fur-
thermore, there is not much investigation of the influence of cultures, cross-cultural
individual determinants or even of the constantly changing media paradigms. Under-
standing and keeping pace with the changes in such a complex system that englobes
media-based B-2-B communication reverberate in a positive way for marketing pro-
fessionals or information system researchers [14].
B-2-B Communication. Opposite to business-to-customer (B-2-C), B-2-B-oriented
companies do not target private consumers, but design and sell products and services
mainly to organizations, [15]. The B-2-B sector is responsible for a very significant part
of the total industry revenues worldwide. B-2-B communication regards all commu-
nicative activities performed by a company towards the human being as part of a
procuring organization. With respect to the subject matter of communication, not only
products and services can be promoted but also the company as a whole; hence, the
term B-2-B is also regarded in marketing as ‘corporate communication’ [16]. Corporate
communications aims not only to the formation and development of a strong and
unique image of the company’s personality, it also represents communication tools and
activities that are used to represent the company and its services to the relevant internal
and external target groups of communication [17]. More specifically, corporate com-
munications can be divided into three branches: the market communication, the
employee communication and public relations (Fig. 1).
‘Public relations’ ensure the company’s fundamental sphere of influence [18], for
constructing and keeping relationship and trust in social and political contexts [19, 20].
‘Market communication’, in contrast, seeks the economic objective of advertisement,
which means selling products and services to other companies. ‘Employee commu-
nication’ concerns internal necessities and processes, and it is oriented to organizational
stakeholders so as to ensure their incorporation in internal decision-making processes
that aim the corporate development [17]. The latter seeks for higher employee satis-
faction and loyalty, as well as higher productivity and distribution of information and
knowledge inside the organization. The present work refers to the communication
activities of B-2-B-oriented organizations, which target external and internal stake-
holder groups [21].
416 M. Ziefle et al.
Fig. 1. Corporate communications regarding its functions [22]
Media Usage B-2-B Communication. In what concerns the typology of media, there
is primarily the differentiation between individual and mass media [23]. The individual
media can also be termed ‘1:1 media’, since they enable a two-sided interpersonal
(synchronous or asynchronous) commu-nication. Examples are mail, e-mail or tele-
phone. Mass media (1:n media) allow to transmit content to many recipients. Typical
mass media are TV, radio, newsletters, but also classical websites that are based on
one-way communication [24].
With the further development of Internet as ‘Web 2.0’ and of technical devices, as
well as due to the advent of social media tools, another type of media type has
emerged: the so-called ‘n:n media’, which is characterized by the possibility of many
senders communicate with many recipients on a global and public scale. Due to the
intensification of use of n:n media, there is a switch from push to pull communication.
Within push communication stimuli are sent unilaterally and the recipients respond to it
or not. Pull communication, in contrast is based on dialogue. The users search actively
for the information they need, recommend – or not – services and products (the
‘word-of-mouth’), and step into dialogues with companies, not only for information but
also in order to give feedback.
Due to the increasing development and successful diffusion of the already men-
tioned Web 2.0 technologies, companies were induced to gradually adopt the new tools
for means of corporate communication. While B-2-C-oriented enterprises adapted more
quickly to the new reality, B-2-B companies are still beginning to keep pace with the
times [11]. Finally, since B-2-B communication is situated in the middle of a process of
turnaround from push to pull communication strategies, it is still characterized by the
broad use of both traditional and new media. Therefore, investigating the media usage
in this context requires contemplating both kinds of media (Fig. 2).
Regarding the traditional 1:1 media, the present work focuses on some
non-electronic media for interpersonal communication, which are face-to-face com-
munication, telephone, FAX and mail. On the other hand, new – and hence
electronic-based – 1:1 media is represented in this work by e-mail, videoconferencing,
instant messenger (e.g. WhatsApp) and online chat (e.g. Google Talk).
Fig. 2. Chosen media for this research
The new 1:n media that are regarded here are websites (in its traditional, not
dialog-based forms) and news portals. Since scientific papers can also be accessed
online, they are also assigned to the category of new 1:n media. As new n:n media
online encyclopedia, weblogs, social networks (both corporate and public), social
bookmarking, RSS feeds, podcasts, video portals and search engines are explored.
Cultural Determinants in B-2-B Communication. In order to operationalize the
concept of culture, the present work is based on the cultural dimensions used in the
GLOBE study, that focuses on culture and leadership and comprises of 61 countries
[25] and reports cultural values and practices across countries, identifying organiza-
tional practices and leadership attributes [26]. Overall, nine dimensions were devel-
oped: (1) Uncertainty avoidance: the extent to which members of a society or an
organization strive to avoid uncertainty by reliance on norms and defined processes.
(2) Power distance: the degree to which members of an organization expect and agree
that power should be equally shared. (3) Collectivism I (societal): the degree to which
social and organizational practices encourage and reward collective distribution of
resources and collective action. (4) Collectivism II (in-group): the degree to which
individuals express price, loyalty and cohesiveness in their groups. (5) Gender Egal-
itarianism: extent to which a society or an organization minimizes gender role
differences and discrimination. (6) Assertiveness: degree to which individuals in
organizations are assertive, confrontational and aggressive. (7) Future Orientation:
degree to which individuals engage in future-oriented behaviors such as planning and
investing in the future. (8) Performance Orientation: extent to which an organization
encourages or rewards group member for performance improvement. (9) Humane
Orientation: degree to which individuals encourage and reward others for being fair,
altruistic, friendly, generous, caring and kind to others.
Age and Technical Generations. Historically, new technologies have caused visible
changes in the way of living, of communicating and even of understanding the world.
A huge body of knowledge is prevailing regarding the influence of age on technology
acceptance [27, 28, 29]. Outcomes revealed that older adults are more hesitant and
show higher levels of difficulty when dealing with new technologies as well as a
significantly different understanding of technology [30]. In this context, the concept of
technology generation does play an important role in the way of dealing with media
and technology. Based on the technological paradigm that reigned in different for-
mative periods [31] distinguish basically between three generational groups: the
Early-technical Generation (65 years old or more), the Household Revolution Gener-
ation (49 to 64 years old) and the Computer Generation (26 to 44 years old) as well as
the Internet generation (14 to 25 years old). This work will rely on this expanded model
of technical generations in order to analyze the influence of age in frequency of use of
media and the trust in media for B-2-B communication purposes.
2 Methods
In this paper we explore the Media Usage in B-2-B Communication and the questions
if media usage is depending on the technology generation and in how far different
cultures do use media differently.
Selection of Countries and Cultures: Brazil and Germany. In order to shed light on
culture-specific and cross-cultural influences on media usage for B-2-B communica-
tion, we chose Brazil and Germany as two exemplary countries, which are comparably
different, and have frequent business collaborations on a B-2-B communication basis.
Although Brazil’s cultural traits had large influence of European cultures – due to
the mother country Portugal and the European immigration in the 19th century –,
a first-time interaction of Brazilians with Germans reveal some clear differences
between both countries.
The mixture of races and cultures, together with the tropical climate, are said to have
produced in Brazil “people of easy-going disposition” [32], who also tend to have a close
distance of comfort, to be tactile and informal. Germans are known worldwide for their
effectiveness, straightforward communication and serious and formal approach [32].
Ultimately, such culture-related characteristics and tendencies may also influence specific
recurrent patterns of media usage [33]. On the base of an interview, which was done prior
to the questionnaire study, a Brazilian marketing specialist, who is also CEO at a big
marketing agency in the country, affirmed that Brazilians “generally try to take the warmth
of relationships into connections through new media, including for professional issues”.
Furthermore, he also claimed, that “Brazilians show a high level of acceptance and vivid
interest for new technologies and media”. In contrast, an interviewed German press and
communications professional stated that the Germans “always look first for the fly in the
ointment (…) when dealing with new technologies and new media”, since they would
tend to be very conservative, perfectionist and cautious.
Questionnaire. The questionnaire consisted of 30 questions and it was divided into six
main parts: (a) culture and decision-making style; (b) self-efficacy when dealing with
technology; (c) typification of the enterprise and working environment; (d) way of
dealing with texts in the B-2-B context; (e) media usage in the B-2-B communication;
and (f) demographic data. The survey was developed in German and translated into
Table 1. Item example of approval of information collection

Cultural dimensions: Which item applies for your country?
Collectivism • The system of seeks for individual interest
Power distance • Heads have the full authority and need obedience
Humane orientation • Most people have a clearly structured life with only few
unexpected changes
Collectivism • Group loyalty dominates individual interests
Collectivism • Clerks are loyal towards the firm they are working for
Assertiveness • Most people here avoid conflicts
Gender egalitarianism • We have gender equality in professional careers is
Future orientation • Most people live for the moment rather than the future
Performance orientation • Students are encouraged to engage for high performance
Portuguese in order to be distributed both in Germany and in Brazil. The questionnaire

was delivered online through personal and professional networks, social media and
third-part indications. Its completion was estimated to take between 15 and 20 min. In
the following we report those sections in greater detail, which will be reported later.
Other parts remain uncovered due to space restrictions.
The first relevant section concerned culture and decision-making style. All
culture-related items were adopted from a short version of the original GLOBE
questionnaire.
The six-point scale ranged from ‘fully applies’ to ‘does not apply at all’ (Table 1).
The next section dealt with media usage for B-2-B communication and collected
data about preferences and frequency of media usage in the working context. The items
displayed both 1:1 and n:n traditional and new media. The seven and six-point scales
(respectively) enabled the frequency range from ‘never’ to ‘every day’.
Sample. A total of 236 people took part, 129 respondents from Brazil and 107
from Germany. Among the Brazilians, 69 % were male (21.3 % female). Among the
Germans, 61.7 % were male (34.5 % are female). Technology generation. The majority
(71 %) belongs to the computer generation (26–48). The second biggest group is
represented by the Internet generation (14–25) with a total of 14 % of all respondents.
The household revolution generation (49–64) is represented by 8 % of participants.
Education. Overall, the sample was highly educated. 72 % of the Brazilians are or have
been in college, or have a higher-level education, being a Master or a post-graduation
qualification. Among the Germans, 62 % also have a Bachelor or Master degree.
Around 8 % of the Brazilians and 5 % of the Germans have done a doctorate. Pro-
fessional experience. Around 97 % of the Brazilian and 89 % of the German
respondents have already been or are professionally active. 45 % of Brazilians have
already worked abroad, most of them (13 %) for more than two years. 36 % of the
Germans have worked or are currently working abroad, the majority (15 %) for less
than six months. 57 % of Brazilian women against 47 % of men have been working
outside Brazil, while 47 % of German men opposite to only 22 % of women have
already worked elsewhere than in Germany. Most of respondents that are working
abroad belong to the computer generation (26–48 years). 5 % of the Gameboy gen-
eration (14–25 years) from Brazil has already been working abroad.
3 Results
Technology Generation and Self-competence when Using Technology. In Fig. 3,

outcomes in technical self-competence are depicted, assessed by a scale of [34]. This
personality attitude is considerably related to technology generation. Putting nationality
aside, the means for the technical generations are M = 76.8 (Gameboy), M = 75.7
(Computer) and M = 66.3 (Household Revolution). Concerning gender, men had
significantly higher scores (M = 78.9) compared to women (M = 65.1). Nationality, in
contrast, did not impact technical self-competence.
Cultural Dimensions in Brazil and Germany. When plotting the means of cultural
dimensions on a radar z, the cultural differences become obvious (Fig. 4).
Mann-Whitney U tests show significant differences between both cultures for the
following cultural dimensions ‘Humane Orientation’ (p = .000), ‘Uncertainty
Fig. 3. Technical self-competence for gender and technology generations in both countries
Fig. 4. Cultural dimensions for Brazil and Germany (Index ranges from 0–100 points)
Traditional 1:n Media

Traditional 1:1 Media
trade fairs
mail
scientific papers
fax
phone newspapers Brazil Germany
face to face brochures
1 2 3 4 5 6 7 1 2 3 4 5 6 7
daily never daily never
Fig. 5. Usage of traditional media in both countries
New 1:1 Media New 1:n Media
online chat
new portals
SMS
nstant messanger
ideo conferences enterprise websites Brazil Germany
email Brazil Germany

1 2 3 4 5 6 7
1 2 3 4 5 6 7
daily never daily never
Fig. 6. Usage of new media in both countries
Avoidance’ (p = .000), ‘Collectivism I’ (p = .000), ‘Collectivism II’ (p = .000),

‘Performance Orientation’ (p = .000) and ‘Future Orientation’ (p = .000).
Use of Media in Brazil and Germany. In the following the media usage in both
countries is reported. Figure 5 shows outcomes in traditional media.
As can be seen, both countries show differences in traditional media usage. By
means of non-parametric Mann-Whitney U tests, the frequency of use of telephone
(p = .002), FAX (p = .005), and mail (p = .000) was more often used in Brazil in contrast
to Germany, while the traditional 1: n media were used comparably often. The next
analysis regarded the New Media (1:1, and 1:n, Fig. 6). Again significant differences
between media usage in both countries showed up. In Germany, instant messenger
(p = .000) and news portals (p = .002) are used less frequent in comparison to Brazil.
Finally we explored the usage frequency of new n:n Media (Fig. 7). Overall it could
be revealed that new n:n Media are statistically significant more frequently used in
Brazil in comparison to Germany (commercial social media tools (p = .014), enterprise
web blogs (p = .000) and video portals (p = .000)).
In order to find out if media usage is impacted by technology generation, we run
Spearman correlation analyses, revealing indeed effects of generational influences
New n:n Media
social bookmarks
podcasts
RSS feed
video portals
enterprise web blogs
online encyclopedia
Brazil Germany
search engine
commercial social media
enterprise social media
daily never
Fig. 7. Usage of new n:n media in both countries
Fig. 8. Correlations between technology generation and media usage
(Fig. 8). All correlations are positive, which means that the higher the age, the more
often the specific media are used for B-2-B communication purposes. However, the
oldest technical generation does not correlate significantly with the frequency of use of
any medium, which probably is due to the small sample. Moreover, concerning the use
of social media for private purposes, the Gameboy generation presents the higher
frequency levels: 78 % of the group said to use social media at home very frequently.
4 Discussion
This work showed that Brazil and Germany have significant differences in their cultural
dimensions: while Brazilians tend to be more relationship-oriented and less meticulous
about the future, Germans tend to avoid uncertainty and prize performance. At the same
time, gender inequality seems to be an issue in both countries. Specific cultural values
of both countries also proved to influence patterns of etiquette regarding formal

addressing and texts for B-2-B purposes. Yet, there is a culture-independent consensus
regarding general formal addressing and the proper use of language, which might be
influenced mainly by the working context.
When it comes to the question if there are differences in media usage across both
countries, at a first glimpse, the general patterns of frequency of use of media are quite
similar. However, there were also differences: Germans tend to use traditional media
more often than Brazilians, who tend to give preference to new media. This finding was
confirmed by the fact that Germany had higher scores regarding the use of traditional
media (telephone, FAX and mail), while Brazil’s higher scores were for the use of new
media (Instant Messenger, news portals, commercial social media tools, enterprise
weblogs and video portals). In order to assess to what extent individual characteristics
impact the use of media for B-2-B communication purposes, age and technology
generations was focused. A construct that clearly bounds age and gender regarding the
use of technology is technical self-efficacy. Findings showed that technical self-efficacy
is closely related to age and gender, and independent from nationality. Both in Brazil
and in Germany, men always report higher self-confidence than women, and younger
people also higher scores than older persons. The cultural-insensitive pattern corrob-
orates earlier findings according to which different technical generations experience
technology in a different way [27, 29]. Whilst older persons prefer the use of telephone,
fax or video portals, showing older people using traditional media more frequently than
new medium, the technical generations correlated differently from ‘age’ when com-
bined separately with specific new media – such as social bookmarks and enterprise
social media. Finally, technical self-efficacy displayed greatest impact on the frequency
of use especially of new n:n media. This shows that higher levels of confidence when
dealing with technology also influence the acceptance and adoption of new commu-
nication technologies in a positive way.
Of course, this work represents only a first insight in the complex phenomenon
“culture”. Critically speaking, culture was treated like a “black box”, which is related to
political, geographic and historical frames. Yet, it is reasonably to assume that the use
of a country as a proxy for culture may be misleading. Although this decision has
helped to operationalize the concept of culture, relevant regional differences from each
country were not taken into account. Also, individual cultural differences were also not
considered. Thus, even though the results regarding cultural dimensions for both
countries were similar to the GLOBE outcomes for both countries, conclusive
assumptions may be premature and have to be replicated in future research.
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Patterns for User Interface Adaptations
Towards Runtime Adaptations for Improving the Usability
of Web Forms for Elderly Users
Gottfried Zimmermann ✉ , Annkristin Stratmann, David Reeß, and Tobias Glaser

( )
Responsive User Interface Experience Research Group, Stuttgart Media University,

Stuttgart, Germany
[email protected], {as198,dr044,tg049}@hdm-stuttgart.de
Abstract. Websites and web applications that require user input via web forms
can be a usability barrier for elderly users if not designed carefully. This issue is
even compounded by a broad diversity of needs and preferences as observed in
this group of users. In this paper, we report about a current study in which we
prototypically implemented and empirically evaluated four exemplary patterns
of user interface adaptation. These patterns allow for dynamic substitution
and/or augmentation of user interface parts at runtime, with the goal of improving
the individual usability for an elderly user in a specific use context. This approach
could eventually lead to highly personalized web forms within GPII and URC
enabled infrastructures.
Keywords: User interface adaptation · Personalized user interface · Web forms ·

Supplemental user interface resources · GPII · URC
1 Introduction
User interaction with Web forms can be challenging for users, in particular for older
users1 who are unfamiliar with entering data on the Web [1]. Web forms that are not
designed with elderly users in mind often result in low usability for those users, causing
high error rates, poor efficiency and a low user satisfaction.
Many websites require form input from their users. This applies in particular to public
Internet services (e.g. online government services, online banking, online shops, online
travel agencies) which are becoming more and more essential for the citizens. With an
increasing portion of people belonging to the group of “elderly people” due to the
demographic change, it is important to allow for their full participation in a digital
society.
1
The term “older users” is often used for people of age 50 + , but this is not consistent throughout
literature. In this paper, the terms “older users”, “elderly users” and “seniors” are used as
synonyms.

DOI: 10.1007/978-3-319-20892-3_42
Patterns for User Interface Adaptations 427
However, there are a vast number of websites that have not been designed with the
needs of senior citizens in mind. Also, many web designers and developers are currently
working on Internet services of the future, but do not have the knowledge and expertise
to design them in a senior-friendly way. Is it possible to repair the existing online services
with regard to their usability for elderly persons? Can we do so in a well-structured
approach, driven by patterns of replacement and/or substitution, even at runtime?
Older adults are quite diverse in their digital interface preferences and needs [2]. The
diversity is caused by factors such as their previous technical education and experiences,
and their attitudes, but also by their abilities (in particular cognitive, motor, seeing,
hearing) which may be affected by age [3]. Therefore, older users should not be under‐
stood as one coherent user group, as represented by one persona only.
A “one size fits all” approach would not be adequate for meeting the needs of elderly
users. Therefore, the Global Public Inclusive Infrastructure (GPII) [4] promotes a “one size
fits one” approach in which a user interface is adapted based on the needs and preferences
of an individual user. Nevertheless, it is useful to investigate candidate patterns of user
interface adaptation with regard to how many users could potentially benefit from them. In
this paper, we focus on patterns that could be applied on Web forms at runtime to cater for
“quick fixes” to improve the personal experience of a particular user.
The remainder of this paper is structured as follows: Sect. 2 provides an overview
of existing guidelines on the design of web forms for older users. In Sect. 3, we briefly
explain the concept of user interface adaptations at runtime for the purpose of improved
usability. Section 4 proposes some exemplary patterns of user interface adaptations that
could be applied on Web forms, and reports about empirical findings of a study on these
patterns. Finally, we provide conclusions in Sect. 5, and relate the study’s results to the
future of user interface adaptations.
2 User Interface Guidance on Web Forms for Older Adults
The American Association of Retired Persons (AARP) published a literature review on

designing web sites for older adults in 2004 [3]. This literature review and some follow-
up empirical research [5] resulted finally in 20 high-level heuristics (broken down into
checklist items) for “understanding older adults as web users” [6]. Among them, the
heuristics on using task-relevant and familiar images for buttons (checklist items 2.5
and 2.6), and on avoiding scrolling lists (checklist item 4.3) relate to our pattern on using
push-buttons vs. drop-down menus (see Sect. 4.1). The heuristic on descriptive error
messages (checklist item 7.1) contributes to our pattern on validation on submit vs.
validation on input field (see Sect. 4.2). Also, the advice on making pages look clean
and well organized as opposed to being cluttered or busy (checklist item 13.1) is relevant
for our pattern on the display of help text (see Sect. 4.4).
Kurniawan and Zaphiris structured existing guidelines on web design for older
people in eleven categories containing a total of 38 guidelines [7]. Among them, the
guidelines on simple and meaningful icons (H2.3) and on avoiding pull-down menus
(H3.4) are a direct input for our pattern on using drop-down menus vs. push-buttons
(with graphical symbols) (see Sect. 4.1). The advice on simple and easy-to-follow error
428 G. Zimmermann et al.
messages is reflected in our pattern on validation on submit vs. validation on input field
(see Sect. 4.2).
The National Institute on Aging in the United States has released their own set of
guidelines for making websites “senior friendly” [8]. Among them, the guidance on
using the same symbols and icons throughout a website (under the layout category) is
relevant for our pattern on using drop-down menus vs. push-buttons (with graphical
symbols) (see Sect. 4.1).
Pernice et al. [1] developed 106 design guidelines for “seniors citizens on the web”,
based on quantitative research. Their advice on presenting error messages clearly
(guidelines 34) relates to our pattern on validation on submit vs. validation on input field
(see Sect. 4.2). The guideline on showing only pictures that are clear or can be easily
zoomed in is reflected in our pattern on making images available in enlarged format (see
Sect. 4.2). The advice on being forgiving of errors in forms is a direct input for our
pattern on validation on submit vs. validation on input field (see Sect. 4.2). While Pernice
et al. do not completely discourage designers from using drop-down menus in general,
they remind designers of the difficulties that could come with them for older users
(guideline 92). Considering their guidance on ensuring that images are easy to see
(guideline 53), our pattern on using drop-down menus vs. push-buttons (with graphical
symbols) can be seen as a natural application of these guidelines (see Sect. 4.1).
Almost all guidelines emphasize that their application will make websites easier to use
for all users, not only for older users. In particular, Chadwick-Dias et al. [9] report about a
study in which performance improved significantly for both older and younger users when
a website was redesigned to accommodate the usability issues that older users had.
3 Dynamic User Interface Adaptations
We postulate that it is possible to improve usability of Web forms for elderly users by
applying dynamic adaptations on its presentation, structure and content. The adaptations
could be performed at runtime, based on previously identified replacement and augmenta‐
tion patterns. For example, one of the replacement patterns we investigated is to replace a
drop-down menu with text entries by a set of push-buttons with graphical symbols. We
assumed that elderly users prefer the set of graphical push-buttons because here they see
their choices more plainly, without having to click on a small button to open a list of text
entries. The result of the investigation on this and other patterns is presented in Sect. 4.
In [10], a framework for the development of fully adaptive user interfaces is
presented, consisting of the following six steps:
1. User Interface Modeling. An abstract user interface is modeled (development time).
2. Default User Interface Design. A default user interface is designed, based on the
abstract user interface model (development time).
3. Supplemental User Interface Design. Supplemental user interfaces for specific
contexts of use are designed, based on the abstract user interface model (between
development time and runtime).
4. Context of Use Instantiation. At runtime, a context of use is identified, including
concrete values for a user model, a platform model and an environment model.
5. User Interface Accommodation (System-Driven). The system dynamically adapts its

user interface to be tailored for the concrete context of use (at runtime). Dynamic
adaptations can use the supplemental user interface components of step 3 (this is
called user interface integration) or just “tweak” some aspects of the user interface,
e.g. font size or mouse speed (this is called user interface parameterization).
6. User Interface Customization (User-Driven). The user requests the system to adapt
its user interface along pre-defined options. This can happen through user interface
integration and/or user interface parameterization at runtime.
In this 6-step framework, patterns for improving the usability would be prepared in
step 3 (supplemental user interface design), and would be applied either automatically
as part of step 5 or – on user request – as part of step 6. In case of automatic (system-
driven) pattern application (step 5), the system would first check the given context of
use (step 4) and whether the application of the pattern is likely to improve the usability.
This could potentially involve a matchmaker [11] for finding best adaptation candidates
for the concrete context of use, and potential user interface adaptation patterns. These
patterns could be provided as a pool of supplemental user interface resources (step 3)
and possible parameters for user interface parameterization. In case the user requests
the adaptation along a pre-defined pattern (step 6), this would be stored in the user model
part of the context of use, so that the system would remember the user’s preferred pattern
for the upcoming interaction sessions.
MyUI [12] is a pattern-based system for user interface adaptations. It automatically
generates a user interface at runtime, based on an abstract user interface description
borrowing elements from state machine diagrams (called abstract application interac‐
tion model). MyUI lacks a possibility for designers to hand-craft a user interface (step
2 of the 6-step framework) which is usually an important aspect for today’s design
processes. Also, designers and developers are usually not familiar with the development
of abstract user interface models based on state machines, and prefer imperative
approaches. Nevertheless, MyUI’s adaptation patterns have influenced our thinking
about dynamic adaptions for elderly Web users.
For other work related to user interface adaptations, refer to [10].
4 Exemplary Patterns of User Interface Adaptations
As described in Sect. 2, there are a large number of design guidelines available on how
to make websites and web applications easy to use for older users. Many of these guide‐
lines are supported by empirical data. However, we wanted to make the case for partic‐
ular patterns of dynamic adaptations that could be run automatically to make web forms
easier to use for an elderly individual. These should be applicable even when the author
of the web form did not consider the needs and preferences of older users at all. There‐
fore, we decided to prototypically implement a selection of four substitution/augmen‐
tation patterns of which most are based on or related to existing guidelines (see Sect. 2).
The prototype was implemented with Axure RP.2
2
http://www.axure.com/.
In a study with desktop computers, we tested these patterns on acceptance for older
adults. We had a total of 15 subjects (4 women, 11 men), aged between 64 and 84. We
asked them for their experience with computers and the Internet. 10 subjects had already
used computers in their workplace, 13 had used emails for communication, and 9 had
already ordered a product in an online shop. During our observations, we noticed that
10 of the subjects used the tab key to navigate between input fields, which is an indication
that they were quite familiar with the web and its forms.
Every subject got the same set of tasks:
1. Search for a specific product (sweater or t-shirt).
2. Put two pieces of the product in size “M” into the shopping cart.
3. Proceed with the payment process.
4. Enter name and address for delivery.
5. Pick a delivery method.
6. Pay with a credit card (a “faked” MasterCard was given to the user for this purpose).
In this set of tasks, we exposed the participants to four patterns of user interface
adaptation, each coming in two versions (see subsections 4.1–4.4). For example, we had
them order a sweater, whereby they had to choose the size from a drop-down menu
(version A). After that, they had to order another sweater, this time selecting the size
from a set of push-buttons with graphical symbols and letters for the different sizes
(version B). We varied the order of version A and version B between subjects to counter-
balance possible learning effects. At the end of the test, we collected feedback from the
users on the different versions of the patterns.
The following subsections describe the patterns and the pertaining results of the
empirical study.
4.1 Drop-Down Menu vs. Push-Buttons

In general, expandable menus that require a user action to open are often considered an
issue for older users (see Sect. 2). This can be attributed to dexterity issues and cognitive
difficulties. The menu choices are hidden and become only visible after clicking on a
small button at the right of the drop-down menu field. Obviously, this is also an issue
for users of touchscreen devices since it is hard to hit the “open menu” button with the
finger. Also, if the user is not familiar with a drop-down menu, they may not know how
to open it.
In our study, we contrasted drop-down menus with text items to sets of push-buttons,
for selection of size and number of shopping items. In the choice of size, we also added
the letter “S”, “M” or “L” on top of the symbol to make their meanings more obvious
(see Fig. 1).
The seniors’ feedback was not completely uniform. Some commended the ease of
recognizing and selecting the pictograms in version B, whereas others – being aware of
their computer expertise – thought the pictograms were inappropriate and made them
feel like analphabets or children. Also, some wanted to have a text input field for the
number of items, so they would not be restricted to the values 1, 2 and 3.
Fig. 1. Version A (left) and version B (right) of the pattern “drop-down menu vs. push-buttons”,
implemented as part of a product page. In version A, size and number of items must be selected
from a drop-down menu. In version B, push-buttons are shown for size and number.
4.2 Make Images Available in Enlarged Format

In many online shops it is already customary to have high-resolution versions of images
available upon demand (often triggered by clicking on a magnifier glass icon in the upper
left of the image). While the image file may only be available in low resolution – if the
author of the web page did not bother to provide different versions of the image – a
system could always add an “enlarge image” function at runtime. Once activated, this
function would display the image on a larger area by stretching (e.g. in a popup window,
see Fig. 2). For many users – in particular those with low vision – the fact that the large
image version is not rendered in high resolution would be a minor problem, as long as
the image is enlarged.
Most participants found that the possibility of enlarging the product images improves
the website’s ease of use. Many senior users were already familiar with this functionality
due to its widespread use in online shops. Some even wanted to have multiple views on
the items, e.g. from different perspectives, or have selected areas of the image magnified.
4.3 Validation on Submit vs. Validation on Input Field
Clear and descriptive error messages are an important aspect of senior-friendly websites
(see Sect. 2). A related aspect is the timing of warnings in case of invalid form input.
The user may be alerted to validation errors only after they have filled out and submitted
the complete form (pattern version A), or they may get a message right away when they
have left an input field with invalid content (version B). Figure 3 shows our prototypical
implementation of this pattern, in both versions.
All participants were either pleased with the validation of input fields upon focus
change (version B), or had a neutral opinion. One user appreciated the direct feedback
– or better in this case the absence of a negative feedback – as a kind of reward for a
doing a good job. The validation upon submit (version A) caused confusion for some
elderly users since they did not immediately understand what the problem was and what
they had to do to be able to move on.
Fig. 2. Version B of the pattern “make images available in enlarged format“. On every product
image, a magnifier class with a ‘+’ sign is superimposed in the upper left corner. If the user clicks
on it, a large image version is displayed in a popup. Note that version A (no screenshot included)
has no magnifier glass on images, and the user cannot request an enlarged image version.
Fig. 3. Version A (left) and version B (right) of the pattern “Validation on submit vs. validation
on input field“. In both versions, the user did not enter their first name. In version A, the red
validation message is only shown after the user has pressed the “submit” button (not included in
the screen shot). In version B, the user is alerted to the error as soon as they set the focus to the
next field.
4.4 Display of Help Text
Help texts for web forms can be presented to the user in various ways. Some websites
display hints and help texts openly, others on the press of a button. Recently, some
websites have provided hints as “placeholders” in input fields, but unfortunately a
placeholder text disappears as soon as the user sets the focus in the field. On the other
hand, hints and help texts may clutter the screen and distract the user (see Sect. 2).
In our fourth pattern, we implemented two versions of help text display for input
fields. In version A, the help text appears below the input field when the user clicks on
a button with a question mark (‘?’). The button is placed to the right of the input field.
The help text disappears again when the user leaves the input field. In version B, the
help text is shown automatically when the user sets focus to the input field, and disap‐
pears when the user leaves the input field (see Fig. 4).
Most users did not notice the help texts, neither for version A nor for version B. When
asked for feedback, they deemed the input for name and address fields as trivial and not
requiring any hints beyond the label. However, they appreciated help for more complex
input fields such as the expiration date of the credit card. Here, they wished a permanent
display of help text that would not disappear when moving away from the input field (as
opposed to both versions implemented in our prototype), e.g. in the form of a long label.
4.5 General Observations
Aside from the assessment of the four patterns for user interface adaptation, the study
brought about some other findings that could potentially be used in automatic user inter‐
face adaptations.
In general, participants had problems in recognizing that they needed to scroll verti‐
cally to get to the screen elements “below the fold”. This problem is a common finding
and reflected in various guidelines (see Sect. 2). An adaptation system could automati‐
cally break up one page into multiple pages to avoid the need for scrolling.
A related problem occurs when – upon a submit operation – error messages are
displayed in a part of the screen that is currently not visible due to scrolling. This could
be avoided by automatic scrolling or – even better – by validating upon leaving an input
field rather than upon submit (cf. Sect. 4.3).
When filling out web forms, many participants used either all-capital characters or
all-small characters in their typing. An adaptation system should be tolerant to this
practice, and could further automatically correct the character case where appropriate.
The division of first name and surname into two input fields was unnatural for some
participants. They entered their full name into the field for the first name, and noticed
their mistake when they got to the next input field (requesting the surname). The same
occurred with the input fields for street name and house number, and with the input
fields for the expiration date of the credit card (month and year). An adaptation system
could recognize these user input mistakes and automatically split the input and distribute
its pieces into the appropriate fields.
Fig. 4. Version A (left) and version B (right) of the pattern “display of help text“. In both versions,
input fields for the ZIP code and the city are displayed, and a hint is shown under the first input
field: “Enter your ZIP code”. In version A, the hint is shown upon pressing a ‘?’ button. In version
B, the hint is always shown when the focus is on the input field.
On typing their email address, many seniors typed a comma (‘,’) instead of a dot (‘.’)
due to vision and dexterity problems. This mistake could also be automatically corrected.
For the credit card, some participants entered its number in blocks of 4 digits, with
spaces between the blocks. In fact, this allows for easier reading and double-checking
of the number. An adaptation system could offer separate input fields for each block,
and automatically jump to the next block when a block is full.
A frequent issue for the senior users was the entry of the 3-digit card validation code
which they were not familiar with. An adaptation system could provide additional guid‐
ance for this input field on request, for example by a photo explaining where this code
can be found on a real credit card.
Some participants did not have an email address. Therefore, an alternative contact
for clients should be offered (e.g. a phone number), and the email address field should
not be a mandatory field. While this problem cannot be easily fixed at runtime, it could
be part of guidelines for web authors.
5 Conclusions and Outlook
The findings of this paper relate to the concepts of the Global Public Inclusive Infra‐
structure (GPII) [4], and the Universal Remote Console (URC) framework [13]. We
have identified four exemplary patterns that can facilitate the dynamic personalization
of Web forms at runtime. This approach fits well within the framework of fully context-
sensitive user interfaces [10], in particular for the steps on “user interface accommoda‐
tion (system-driven)” (step 5) and on “user interface customization (user-driven)” (step
6) (cf. Sect. 3). As always, the user should be in control over the adaptations performed,
even though the system may anticipate and propose specific adaptation patterns.
It is important to note that for many adaptations at runtime, the author does not need
to be involved. In fact, all exemplary adaptation patterns presented in this paper could
be achieved in a fully automated fashion and facilitated by third-party authors providing
supplemental user interface resources before runtime. Supplemental resources for
personalization can be deployed through an online resource server [14] if the basic
structure and abstract content of the user interface is known before runtime. Of course,
the provision of supplemental user interface resources has significant security implica‐
tions. Care needs to be taken for such a framework to prevent from malware sneaking
in through the door of “supplemental resources”.
None of the patterns that we investigated had a clearly superior version that would
be preferred by a majority of users. Instead, this study confirms the findings of others
that elderly users are a rather heterogeneous audience with a broad diversity of needs
and preferences (see Sect. 2). The group of elderly users makes a strong case for the
concept of personalized adaptations on user interfaces, as facilitated by the GPII and
URC frameworks. Therefore, the question resulting from this study is not which version
to implement for an adaptation pattern, but rather to allow for all versions to be available
as possible adaptations for a user interface. That way a suitable version can be selected
and instantiated at runtime, driven by the actual context of use, including the user’s
personal needs and preferences.
Acknowledgments. We thank Dr. Ulrich Schloz for his kind support in facilitating the user tests
with seniors from the association “Senioren Online” in Reichenbach, and from the association
“Arbeitsgemeinschaft Mikroprozessor und Minicomputer” in Stuttgart. We also thank the nursing
home “Seniorenzentrum am Rosengarten” in Bondorf for their support and participation in the
user tests.
The research leading to these results has received funding from the European Union Seventh
Framework Programme (FP7/2007-2011) under the grants 289016 (Cloud4all) and 610510
(Prosperity4All). This publication reflects only the authors’ views and the European Union is not
liable for any use that may be made of the information contained herein.
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The Elderly and Mobile Devices
Older People’s Attitude Towards Mobile
Communication in Everyday Life: Digital
Literacy and Domestication Processes
Francesca Comunello1,3(&), Simone Mulargia2,3, Francesca Belotti2,

and Mireia Fernández-Ardèvol3
1
Dipartimento Di Scienze Umane, Lumsa Università, Borgo Sant’Angelo 13,
00193 Rome, Italy
[email protected]
2
Dipartimento Di Comunicazione E Ricerca Sociale, Sapienza Università
Di Roma, via Salaria 113, 00198 Rome, Italy
{simone.mulargia,francesca.belotti}@uniroma1.it
3
Mobile Technologies and (G)Local Challenges Research Group IN3,
Universitat Oberta de Catalunya, C/Roc Boronat 117, MediaTIC Building, 08018
Barcelona, Catalonia, Spain
[email protected]
Abstract. Older people’s attitude towards mobile communication constitutes a

privileged perspective for analyzing domestication processes of digital tech-
nologies. By means of a qualitative case study conducted in Italy, we study older
users’ motivations and usage practices. We focus on perceptions of mobile
phones, adoption and domestication of mobile phones, as well as on usage
skills. Participants, aged 60 to 95 years old, typically started to make use of
mobile telephony in mid 1990 s and they mainly described a utilitarian approach
to the mobile device even though there are cases of anthropomorphization. With
a variety of profiles, from assisted to advanced users, those not having smart-
phones sometimes see touchscreen as challenging. They describe different
learning strategies, which are shaped by personal interests. Finally, some par-
ticipants adopt more sophisticated devices while others decide to slow down
their relationship with mobile phones.
Keywords: Mobile telephony Older people Domestication Learning

strategies
1 Background
Mobile technology plays an increasing role in everyday interpersonal communication,

representing a useful resource for different age cohorts. A wide number of publications
deal with the usage of mobile phones by younger people: mobile phones re-place their
personal interactions [1], are tools of emancipation from the family and facilitate social
cohesion in the peer group [2]. Young people have created and implemented new
communication practices [3], so that the appropriation of mobile telephony is com-
monly perceived as a juvenile phenomenon. Yet, the usage by older people is worthy to

DOI: 10.1007/978-3-319-20892-3_43
440 F. Comunello et al.
be studied as well, firstly because in European societies older population is steadily

growing [4]. The age structure of the population will change, with an increasing share
of over 65 and a declining share of younger and working age persons [5]. Thus,
focusing on the elderly and their use of the mobile phone means considering an
increasingly growing section of the European population.
Furthermore, the relationship between the elderly and the mobile phone is inter-
esting because it is the most popular information and communication technology
(ICT) among older people, who show the lowest levels of ICT adoption. Thus, it is
important to explore the relationship older people have with mobile telephony, con-
sidering that ageing shapes physical characteristics, basic abilities, communication
habits and the choice of media. Several studies show that the elderly might face
cognition and reading capacity challenges [6, 7], or problems in handling small devices
and using messaging services [8, 9]. Nevertheless, mobile phone adoption keeps
growing among the elder, while it is common for them to incorporate innovative
communicative practices [10].
2 Theoretical Framework
All these aspects justify a special focus on seniors’ relational and communication prac-
tices that show a relevant role of mobile phones both for personal safety and for social
interaction. Age, thus, appears as a key factor affecting mobile phone’s adoption and
usage style [11]. Seniors are individuals who have been introduced to mobile commu-
nication late and mainly under the “pressure” coming from their closed social circle [12].
Nowadays, as society shifts towards networked individualism [13] and networked
sociability [14], older people keep up and experience new patterns of sociability built on
me-centered networks [15] that are growingly enabled by mobile technologies.
2.1 Domestication
In order to analyze older people’s acquisition and consumption of mobile phone tech-
nology and their usage of mobile phone in everyday life we mainly rely on the domes-
tication approach [16–18]. Paraphrasing Silverstone and Haddon [17] we can assume that
mobile phones are more than merely machines. They can be considered cultural artifacts,
whose meaning emerges at the intersection of technical features and ongoing processes of
social understanding. The process which leads to mobile phone’s incorporation into
everyday life [19] is particularly evident considering older people experiences, because
they have a precise memory of their first contact with this technology and can therefore
offer a rich and detailed narration of their acquisition process.
According to the domestication approach, mobile phone (as other different infor-
mation and communication technologies such as television and the Internet) undergoes a
preliminary process of appropriation by users, characterized by the production of an
analysis that (can) lead to the acquisition of the mobile phone. In this early phase users try
to figure out how ICTs can play a role in everyday routines. Then we observe the
incorporation process, related to the physical location of the mobile phone within the
users’ home and when they carry it with themselves, as this is a portable device. Spatial
Older People’s Attitude Towards Mobile Communication in Everyday Life 441
constraints (such as the lack of signal) contribute to influence users’ choices; nevertheless,
other elements must be taken into account in this process, such as aesthetic reasons or
health concerns. The objectification is related to users’ everyday practices as it considers
how technology use takes its own place in users’ daily routines. Objectification has
therefore to be considered in relation to time structures and time constraints which con-
stitutes limits in users’ action. Everyday usage is not only connected with users’ time
budget, but also with time organization and users’ perception of free time availability. The
conversion process addresses how the presentation of technology produced by the users,
and their reflections on ICTs’ meanings contributes to the definition of users’ identity.
Users, for instance, tend to embed ICTs into their impression management strategies; this
concern about the public image of the individual as an ICT user can even lead to non
adoption phenomena in some cases [20, 21].
According to the domestication approach, mobile phone adoption and usage must
be analyzed considering the role of users’ relational networks. The lack of support from
users’ social networks is, for instance, a key element to understand nonadoption.
Without that potential source of motivation and help for using ICTs, in fact, users in
general (and older people in particular) can simply think that ICTs are not for them
[21]. On the other hand, users’ inclusion in dense social networks is a factor that can
foster adoption processes.
Mobile phone usage in everyday life has been studied in relationship with, among
others, two fundamental dimensions: safety and security issues and microcoordination
[22, 23]. According to Ling [24] mobile phone everyday usage is often related to a
sense of safety and security, especially for older people and for users affected by
a chronic sickness. When coming to be integrated in everyday life, mobile phone offers
a powerful tool to organize users communication and meetings on a real time basis,
enabling a potential rearrangement of trips destination [22].
Even though both mobile phone usage in everyday life and domestication processes
have a well-established tradition of studies, such theoretical perspectives should be
considered as an evolving framework. When launched, mobile phone was considered a
communication tool for businesspersons (among others, due to its high cost). However,
nowadays it has reached almost all the population and the number of users is still growing.
The domestication steps can be placed in a logical sequence, but we can not assume that all
the stages are entered sequentially by all users [20, 24]. Differences among users
belonging to specific age cohorts, gender, and living in different socio-cultural and
country contexts also play a role in differentiating everyday usage practices.
2.2 Digital Literacy

Digital literacy is key in shaping adoption and practices of mobile phone use, which
can constitute a factor both of inclusion and of exclusion from the mobile communi-
cation environment. In our analysis we refer to a broad understanding of digital lit-
eracy, that stresses multiple dimensions, including the social and relational aspects
experienced by users in their everyday life [25–27]. More specifically, van Deursen and
van Dijk [28] propose a framework for analyzing digital skills that includes: opera-
tional skills (the skills to operate digital media); formal skills (the skills needed to
handle the specific structures of digital media); information skills (the skills to search,
select and evaluate information in digital contexts); strategic skills (the skills to employ
the information contained in digital media as a means to reach a specific goal). Even if
his main focus is devoted to a computer-centric environment, Warschauer [29], on the
other hand, underlines the role of interpersonal communication-related skills (com-
puter-mediated communication literacy), as a central element for digital literacy.
Our understanding of digital literacy is also rooted in “second level” digital divide
theories, that abandon any dichotomous vision (often refusing the very label of “digital
divide”), and don’t consider technology acquisition as a linear, unidimensional process
[29, 30]. Following early research on technology adoption, we also recognize that
technology adoption and usage are deeply related to motivation, on the one hand, and
to literacy, on the other hand. In such a complex process, early research has underlined
the role of so-called technology “want nots” [31], including technology “dropouts”
(people who were using technology, but stopped to do so).
Following both the domestication perspective and the digital literacy framework,
we also underline the role of personal networks in technology adoption and usage: a
rich relational network does not only provide motivations for using digital technology
(and, more specifically, mobile phones); it can also provide support in technology
usage, both at an operational and at a strategic level.
3 The Research Project
The goal of this paper is to analyze the usage of mobile phones by the elderly in Italy.
Why and how do older people use mobile phone? How do they adopt and domesticate
the device in their everyday life? What is the level of competence and autonomy they
have gained in handling the mobile phone? Due to such exploratory objectives and for
considering the specific circumstances of the research context, we adopted a qualitative
research strategy facilitating a flexible and interactive design [32, 33].
We conducted 51 semi-structured interviews in Rome and in a mid-sized town in
Umbria (central Italy), between October 2013 and February 2014. Participants are both
men and women from different sociocultural backgrounds. Their age varies between 60
and 95, thus considering elderly a non-homogenous group. We take into account
different age segments, including individuals entering retirement and redefining their
personal autonomy. All interviews have been recorded, transcribed and subjected to
thematic analysis focusing on the following dimensions: personal characteristics;
personal networks; adoption of mobile telephone; consumption patterns of mobile
devices; used mobile services; location and mobility of mobile telephone; current
mobile characteristics; attitude and opinions towards mobile technology.
4 Results and Discussion
The purchase of the first mobile phone happened, in most cases, about twenty years
before the interview. It is the result of different trajectories of acquisition. Some par-
ticipants, for instance, declared to have a precise idea about their special need for a
mobile phone, perceived as a communication tool to be used for work or as a device
able to foster a sense of safety and security. “The first [mobile phone]? I took a mobile
phone thanks to a Coca Cola’s commercial promotion about twenty years ago. I needed
it, also to listen to … I mean, while in the street … something could happen. It was for
security reasons” (M. Male, 60).
On the other hand, some respondents did not play an active role in choosing to
purchase a mobile phone. In some cases, they received it as a gift, or a dismissed device
from their relatives. “I think it was in June 2000. Very late, because mobile phones
were already on the hype. It was a Philips; it was very heavy. So, in June 2000 I had my
first mobile phone, they gave it to me as a gift, they literally imposed it on me” (E.
Male, 60).
Apart from these utilitarian motivations, some participants claim they perceived a
sort of social pressure on buying a mobile phone. Acquiring the mobile phone was, in
participants’ words, a way to connect them to a broader social trend. This sense of
obligation played a role also in delaying the first purchase. “We decided not to buy a
mobile phone; we decided not to yield to the temptation of modern times. […] Then,
technology went on […] It seemed it was only a question of being fashionable, being
“in” or “out”. Twenty-five years ago, mobile phone was a real status symbol. I did not
want to be among “those who”.” (M. Male, 63) “Honestly, I would not say that we
needed a mobile phone. Purchasing it, was a way to align ourselves to some evolutions.
Then, once you have a mobile phone, the need to have it is created” (C. Male, 79).
Acquisition and appropriation processes described by older users tend to be not
linear and, in some cases, even explicitly conflicting. “Because of our age, we had “a
fight with” the advent of new technologies. But, slowly, if you have a little bit of
common sense, you can learn to use them, and you can even learn to manage them” (T.
Male, 70).
After an initial feeling of discomfort related to mobile phone use, a majority of
participants show high levels of integration of the mobile phone in their everyday
routines, even if they cannot be considered as high level users. “Among positive
aspects [of having a mobile phone] I love receiving calls when, for instance, I am on
the beach. That still seems to me a big novelty. Before, we cannot receive calls when
on the beach” (I. Female, 84).
The more the mobile phone is integrated in everyday routines, the more it becomes
a useful tool to manage everyday communications. “I usually use the mobile phone to
manage contacts with artisans, for instance, the chimney sweeper. In the last months,
we needed a lot of artisans to work on our house, and I called them with the mobile
phone” (D. Female 62).
Some participants express a sort of emotional connection with the mobile phone.
When talking about it, some users tend to ascribe human characteristics to the device. It
emerges that mobile phone has undergone a process of anthropomorphization. This
process signals a high level of intimacy with the mobile phone [34] and, in some
occasions, it can be considered as a strategy the users employ in order to face the stress
caused by mobile phone’s adoption [35, 36]. “[Where should the mobile phone be
switched off?] Where it can get under someone’s skin. But, I mean, poor thing, if he is
closed, he cannot do that.” (N. Female, 87) “[Mobile phone] is very important, in my
opinion. You feel relaxed because there is a mate, through which you can reach
whatever” (B. Female, 67).
When considering mobile phone usage skills, participants can be positioned on a

continuum, ranging from basic level usage skills (people using their device only for
phone calls, sometimes without being able to access and use their phone book), to
advanced skills (respondents showing high familiarity with mobile internet, Apps,
geolocalization, etc.). Most respondents can be positioned between the two extremes.
A first level of access to mobile technology can be related to basic operational
skills [28]. More specifically, several users report experiencing physical constraints
when using mobile phones: their sight and their hearing are mostly mentioned as
problematic, but they also report problems related to using their fingers on such small
devices. “[Do you always check who is calling before answering the phone?] Yes.
Well, if I don’t wear my glasses, and I don’t see the person [sic]… it happens to me that
I answer even to people I don’t wish to talk to.” (T2. Female, 66) “[Do you always
carry your mobile with you or do you sometimes leave it at home or somewhere else?].
I carry it on my neck, because, by the way, I’m a little deaf, so, if it’s not on my neck I
can’t hear it ” (P. Female, 70).
Constraints are not referred to as such: the participant does not complain about her
limitations, but, instead, exposes the way in which she copes with them, adopting
specific strategies in order to integrate the mobile phone in her everyday life, despite
her physical handicap.
Some respondents, on the other side, explicitly mention “physical limits” referring
them either to users themselves or to devices: “The mobile has the limit that displays
are too small. It’s our physical limits.” (PS. Male, 67) “Yes, there are clearly some
problems, because, as they have miniaturized everything […] You shift to these [new
mobile phones] where you have such small buttons… you push to write something, but
with our big fingers, you write another thing. Even the LED: if you are in the sunlight,
you can’t see anything” (AB. Male, 62).
Such limitations are mentioned by the older-old as well as by some of the
young-old in the study, particularly by those who have experienced a shift towards
more advanced devices (and especially smartphones). Notably, participants tend to
identify the smartphone with its interface: when talking about smartphones, they almost
always use the English word touchscreen, often referring to it in a problematic way.
User interfaces show their relevance not only in user experience, but also in user
representation of technology. Moreover, while touchscreen is designed to be a “calm
technology” [37], even young-old and well educated users appear to perceive them as a
barrier for accessing more advanced services. “Well, my friends! When I see a friend
who has a touch screen (sic)… how is it called? […] well I admire them because, even
if some of them are older than me, I see that they handle this screen, like that, with their
fingers […] I think it’s not for me!” (DG. Female, 69).
Technology adoption and skill acquisition do not appear as linear processes. Some
users refer to have downgraded their mobile phone use, having given up the most
advanced features (or having stopped using more advanced devices). This is normally
related both to the constant evolution of mobile devices and applications, and to vital
trajectories (some users, for instance, refer to the time they retired as the moment in
which they stopped acquiring new digital skills). Such phenomena are consistent with
the literature on technology acquisition, and particularly with the concept of “want
nots”, as described by van Dijk [31]. “I’ve noticed that, since I retired, there has been
somehow a regression: I used to use the PC in the office, and I’m stuck at that point…
Well, there are many things I was able to do… I’m not able to do them anymore, I get
angry and I give up.”(DG. Female, 69) “Well, at some point the mobile started to show
some flaws, it started losing incoming calls, I tried to call and it didn’t work… So I
bought a device that could only do phone calls.” (G. Male, 77)”Earlier, some years ago,
I did everything with my old mobile phone. Then, do you know what? At some point
[…] I just forgot [how to do things], maybe on purpose. If I go and read the instruction
book, I can maybe succeed, but I started focusing on other things and the phone just
stays there”(PVT. Female, 79).
The mobile phone’s usability may facilitate learning processes, by supporting the
acquisition of new knowledge procedures that are useful to operate and interact with
the device properly [38]. Motivational issues may play an important role as well,
because older adults are stimulated to use mobile phones and learn new functions if
they perceive the need, usefulness or interest in improving their knowledge and
know-how [39, 40]. “[…] the phone calls and all things I need, well, I know how to use
them; and the things I do not need… seeing the Internet on the phone [is not necessary]
for me, what’s more I am blind! [meaning that her sight is low].” (MG. Female, 67)
“[…]the alarm clock, the calculator: no no, I do not use them! But I do not have a good
relationship with the technical tools, so I learn just three things, the necessary ones, and
those I make!” (PB. Female, 70).
One obvious problem for anyone using a mobile phone is approaching and handling a
new device. If we consider that learning ability declines with age, while mobile phones
rapidly evolve in their technological features and services, we can easily understand why
the devices can be perceived as complex by elderly people, who might consider learning
to use them as a difficult challenge [9]. “[…] considered my young age [ironic], when you
switch from one phone to another, you might have some difficulty.”(NI. Female, 84)”The
problem is that, as I was used to a slightly simpler device, this one is a bit more com-
plicated, more complete. It has more functions than the other one. […] In writing mes-
sages, I felt better with the previous one” (PM. Male, 72).
Relevant differences in interviewees’ responses have been observed in relation to
what can be defined as mobile phone-related “learning style”. Overall, the strategy to
find out about new devices or functions seems to follow previous learning experiences,
such as the scholastic one. “[…] in those rare occasions when you use it… “Why does
it do so?”, “I don’t know”… I did not tolerate the answer “I don’t know” as a logic
setting and as a learning culture. When I was young, you could not say “I don’t know”
or “I don’t understand”: they were two banned phrases at school because, if you didn’t
know, you admitted not having studied, and if you didn’t understand, you admitted
being stupid. […] But now you realize [you have] almost infinite learning opportunities
with these tools” (PS. Male, 67).
Participants face the learning challenge either by adopting an exploratory or a
didactic approach. Some of them seem to follow a constructivist model of experiential
learning [41, 42]. By assimilating new experiences into an already existing framework
and accommodating their mistakes or failures, older people autonomously learn to use
the telephone set. This is like an artifact that they appropriate by discovering how to
manage it [43, 44]. They attempt to face a difficulty within an interactive and complex
media environment, such as the mobile phone, and information acquired in this
experience become readily viable in future problem solving. “When I had problems,
somehow I resolved them. It took me a bit more time, but I got out of them […]
Recently I had the problem that I had some photos, and I could not download them into
the computer […] I did it on my own: I downloaded […] and I managed to put them on
the computer […] It was a bit difficult, but I succeed! “(TE. Male, 69) “My wife is who
usually asks me [for help]; then, […] I start trying until I find the solution, because
these gadgets have their own logic; so just understand that!” (G. Male, 77).
Other respondents, on the contrary, seem to adopt an instructionist model, as they
learn by means of an external transfer of knowledge. This approach is teacher-focused,
skill-based, goal-oriented and not always interactive [45]. Users prefer to learn by
consulting user’s manual – though blaming instructions for being not so intelligible –
or “teachers” who can bring them specific advice to use mobile phone. “I don’t have
the imagination to start reading the rules, I mean the [user’s manual] […] maybe you
could use it more and have greater advantages. But compared to what I need, the game
is not worth the candle! They should make [the instructions] a little bit more practical
and synthetic, not [those] books!” (PG. Male, 67 “[Did you install the email on the
phone by yourself?] No […] At the store […] I asked them to install all the things I
needed […]. I got them also to explain me how I had to do, I even wrote it on a little
note book, at the beginning; then now I no longer need to read it” (B. Female, 67).
Nevertheless, this latter attitude is not necessarily passive as it can be based on the
interaction between “pupils” and “teachers”. In fact, many interviewees who adopt the
instructionist approach usually turn into warm experts [46] for their peers. As personal
social networks are a key element in adopting mobile phones and in acquiring the
related usage skills, respondents mainly rely on younger family members who explain
them how to use basic or advanced functions, thus transforming the teaching process in
a socialization of subjec-tive knowledge [10]. “[Have you ever asked someone for help
in using some function?] Yes, my grandson and my son. These are graduating in
telephony as they go along!”(G. Male, 77)“[Have your grandchildren ever taught you
to use the mobile phone?] Yes, in the early times. […] They taught me: “Grandma, here
you push, here you switch on, here you know when you have used up money”… I even
know that! You can imagine how good I am! […] After [they taught me], I do
everything by myself.”\(NS. Female, 87).
Asking for help is particularly frequent among assisted users, who are only able to
answer calls and hang up, who dial numbers directly as they are not able to use the
phonebook, who do not use any service beyond voice communication and who leave
the handset permanently in a fixed place to keep it safe [47]. Nevertheless, in these
cases there is not a real interactive and cooperative learning situation [48]: when the
younger relative helps the senior and achieves the goal of solving the device’s problem,
the older user does not necessarily learn how to manage that situation, mainly because
he or she is quite satisfied with the already acquired skills. “I have [the mobile phone]
but it is at rest. […] [I use it] Very little. […] [At home], I keep it on this table […], I
leave it there. […] Do you know when I do a call with the mobile phone? When I need
to call my son-in-law, because I have all of his numbers: I just press a number, he has 2,
4 and 8. My daughter has 9 […] [And with your mobile phone do you only call or use
other services?] Nothing else! Only calls […] It does not suit me!. […] [For example,
storing numbers that correspond to your contacts: did you do it by yourself or did you
ask someone for help?] My son-in-law did it for me. I would not know ever do such a
thing.” (NN. Female, 86).
Overall, women tend to rely on their male spouse as they are influenced by gen-
dered stereotypical (self)representation. In fact, participant women take for granted they
are less likely to use digital technology and less competent, although they are actually
building up intimate relationships with technology and are becoming advanced users
[49]. Some men users refer to their partners as an example of lack of technological
expertise; likewise, some women consider the male partner as a driver of innovation,
even if their own level of usage skills and technological aptitude is not low. Conse-
quently, women do not perceive any social expectation of competence and autonomy in
the use of technology and, thus, are more inclined to ask men for help. “[Is there
anyone else who uses you cell phone?] My husband […] [If you must change the
settings, do you ask someone?] I do not know how to do anything with the mobile
phone.” (I. Female, 84) “[Have you ever been asked to advise someone on how to use
the mobile phone?] My wife, because she is more useless than me […]. Sometimes she
is in trouble, she asks the children for help; but the children are always evasive or show
her electronically, ta-ta-ta-ta, so that she cannot follow them. Thus, sometimes she turns
to me, especially when she needs to send a text message” (T. Male, 69).
An exception to the rule of relying on relatives can be traced, however, in those
interviewees who report not to rely on relatives for privacy reasons, sometimes preferring
to turn to professional figures, such as the shopkeepers. “It is handled only by me; but iffor
example I have to configure it for browsing the Internet or receiving emails - I have a
Smart Phone - I go to a specialized store that set it for me. [For example, your wife or your
children, friends, colleagues… does it happen that they handle your mobile phone?] No, it
is always under my close supervision!” (MVT. Male, 61).
In any case, once participants become familiar with the device, they feel more
comfortable with it; so that in some cases they prefer to buy a new device similar to the
previous one, to avoid extra learning costs. “As the other [device] broke down, now I
bought one like that because I tend to buy similar mobile phones, so I don’t have to
re-learn!” (T. Female, 66).
5 Conclusion
The mobile phone has already become an ordinary object among the 60 + years old
participants of the study conducted in Italy. Interviews brought evidence of the four
phases of the domestication process. Firstly, appropriation. We identified participants
who bought their first mobile phone to avoid being out of the general adoption trend even
though they did not feel the mobile as something needed in their lives. Yet, other par-
ticipants did not make a decision on acquisition but received the handset (new or used)
from a relative. Most of them had been using the mobile phone for twenty years. However,
some of them, based in their peers’ experience, expressed their concerns towards moving
into a touchsecreen device (i.e., smartphone). This can be interpreted as one of the steps of
the analysis that may, or may not, end in the acquisition of a new device.
Secondly, incorporation. Physical condition might shape the location of the mobile
phone when we consider it a wearable. When usability issues appear in the first stages
of adoption they may lead to rejection of the tool. However, if the device is already part
of everyday routines, specific strategies might arise. We understand this is the case of a
70 years old woman who decided to wear the mobile on her neck because she was
“slightly deaf”.
Thirdly, objectification. Regardless of their skills, all the older participants report
using mobile phones as a tool for managing everyday life activities. However, routines
can change throughout time and individuals can decide either increasing use or
reducing it, a decision that depends on personal interests and on the effort needed to
operate the device. In addition, we found cases of anthropomorphization which denotes
high degrees of intimacy with the device.
And fourthly, conversion. A particular result of this research is not only that women
tended to define themselves as less skilled, but men also considered themselves more
skilled than women, which denotes gendered stereotypical (self)representations.
Learning strategies in the case of mobile phones need to be permanently adapted, as
ICTs are in constant evolution. Participants, in general, were attached to their previous
learning experiences but described different learning strategies. Some took an
exploratory approach, based on learning by doing; others preferred to rely on the users’
manual and follow its instructions. In any case, the personal network was important as
it shaped the expectations and pressures any individual would face for adopting, in this
case, mobile communication. More importantly, close relatives could bring support,
either to assisted or to more advanced users. Finally, older individuals who acquired
enough skills can turn into supporters (teachers) of their peers.
In sum, stages of domestication and learning strategies are not homogeneous,
which confirms the need to approach the study of the relationship older people have
with mobile telephony by taking into account their heterogeneity.
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Differences in the Adoption of Smartphones
Between Middle Aged Adults and Older
Adults in China
Shang Gao1(&), John Krogstie1, and Yuhao Yang2

1
Department of Computer and Information Science,
Norwegian University of Science and Technology, Trondheim, Norway
{shanggao,krogstie}@idi.ntnu.no
2
School of Business Administration,
Zhongnan University of Economics and Law, Wuhan, China
[email protected]
Abstract. This research aims to investigate the differences in the adoption of

smartphones between middle aged adults and older adults in China. Based on a
literature review from previous research, a research model with eight research
hypotheses was developed by extending UTAUT with a consideration of
observability and compatibility from IDT, and perceived enjoyment and price
value. This research model was empirically examined using survey data from
196 middle aged adults and 146 older adults respectively from China. The
findings indicated that the effects of perceived enjoyment, compatibility, and
observability on users’ intention to use smartphones were significant, but no age
differences between middle aged adults and older age adults were found to exist.
Furthermore, the findings also identified age-related differences in the use and
adoption of smartphones. The effects of performance expectancy and social
influence on users’ intention to use smartphones were moderated by age, such
that it was significant for older adults but insignificant for middle aged adults.
Keywords: Adoption of smartphones UTAUT Older adults Middle aged

adults
1 Introduction
Today, smartphones become increasingly important in peoples’ daily life [7]. However,
not everyone are using and adopting smartphones. For example, many older adults are
still using basic mobile phones in China. The digital divide remains when it comes to
new technologies [10]. The digital divide refers to the gap between those who do and
those who do not have access to new forms of information technology [20]. Middle
aged adults and older adults face challenges when they are using smartphones. A gap
seems to exist in the adoption and use of smartphones by middle aged adults and older
adults. We would like to examine the use and adoption of smartphones with both
middle aged adults and older adults in China.
The objective of this research is to examine the adoption and usage of smartphones
with both middle aged adults and older adults in China. This research aims to make

DOI: 10.1007/978-3-319-20892-3_44
452 S. Gao et al.
contributions to studies on ageing and the adoption of smartphones. We investigated

how various factors impact middle aged adults’ and older adults’ intention to use
smartphones in China by a research model based on previous technology diffusion and
acceptance theories (e.g., [18, 22]). Since most previous research (e.g., [15, 24]) on the
adoption of smartphones tended to focus on people below the age of 35 (e.g., students,
young people), we wanted to examine the user group with people over the age of 35 in
this study. We defined older adults as people over the age of 45 in this study and
middle aged adults as people between the age of 35 and 45.
The remainder of this paper is organized as follows: Sect. 2 discusses the theoretical
background of this study. The research model and hypotheses are presented in Sect. 3.
The research method and results are described in Sect. 4. This is followed by a dis-
cussion of the findings in Sect. 5. Section 6 concludes this research.
2 Background
2.1 Digital Divide
Scholarly research on the digital divide has a long history back to the 1990s. There is
well documented research (e.g., [3]) on digital divide connecting to Internet and
computer penetration through the lens of technology diffusion theory (e.g., TAM [4],
IDT [18], UTAUT [22]) in the past two decades. Digital divide is generally referred to
as the ‘uneven diffusion’ or ‘gap’ or ‘disparities’ between different socio-economic
levels or across countries or between developed and developing countries in terms of
‘access’ and ‘use’ in ICTs [12]. Research on digital divide often starts by looking at
users’ access to new technologies. Along with the popularity of computers and digital
technologies, the digital divide in terms of physical access seems to be reduced in most
developed countries. Van Dijk [20] found a shifted research attention on digital divide
from physical access to skills and usage.
The uneven spread of the mobile applications on smartphones has contributed to
the popularity of the concept of the ‘digital divide’ associated with smartphones. It
highlights the emerging social gap between those individuals who use mobile appli-
cations on smartphones and those who do not. It is believed that a significant com-
ponent of the digital divide is age. For example, some older adults may feel no need for
smartphones because they are not aware of the benefits of smartphones. To reduce
digital inequalities, we must understand the reasons for different age groups’ resistance
to the use of smartphones. Investigating this digital inequality is of help to understand
the diffusion of smartphones with populations of different age.
2.2 Research on the Adoption of Smartphones

Research has been carried out in studying various aspects related to the adoption of
smartphones [6, 8]. In [5], Gao et al. investigated the role of lifestyles on the adoption
of smartphones. The findings indicated that users with different lifestyles had different
preferences related to different services on smartphones. Based on a study on the
performance of mobile applications, Huang et al. [11] indicated that smartphones could
Differences in the Adoption of Smartphones Between Middle Aged Adults 453
become a suitable substitute of the traditional computer. But, the performance of the
applications on smartphones is poorly understood.
Although significant effort has been done to explore the adoption of smartphones,
the samples used in previous research on the adoption of smartphones were relatively
young. An examination of the current literature reveals that few studies have addressed
the use and adoption of smartphones by middle aged adults and older adults. In [9],
Gao et al. studied the adoption of smartphones among older adults in China. The results
indicated that perceived enjoyment was the most important determinant for older adults
to adopt smartphones. Pheeraphuttharangkoon et al. [16] investigated the adoption and
use of smartphones with older adults in the UK. However, the sample size with people
over 40 years old in their study is quite small.
This research was a continuing effort from our previous research on the adoption of
smartphones with older adults in China [9]. The digital divide along the age dimension
has become a major concern in China. Two different age groups were defined in this
study. We examined how the role of age played in the explanation of variability in the
intention to use smartphones.
3 Research Model and Hypotheses
A research model that identifies important factors that impact users’ intention to use
smartphones was developed in this research. The proposed research model (see Fig. 1)
is an extension of UTAUT [22], with a consideration of observability and compatibility
from IDT [18], and perceived enjoyment [19, 21] and price value [23] from other
technology diffusion theories. We have developed the following eight research
hypotheses (labeled in Fig. 1) based on the research model.
Hypotheses Developed from UTAUT. Four key factors from UTAUT, Social
Influence, Facilitating Conditions, Performance Expectancy and Effort Expectancy,
Fig. 1. Research model

454 S. Gao et al.
were included in our research model. Social Influence is the extent to which users
perceive that important others (e.g., family and friends) believe they should use a
particular technology. Previous research also indicated that social influence is impor-
tant for the adoption of smartphones [25]. Facilitating Conditions refer to users’ per-
ceptions of the resources and support available to perform a behavior. Users need to
have digital skills to use smartphones. Performance Expectancy is defined as the degree
to which using a technology will provide benefits to consumers in performing certain
activities. Smartphones are able to provide potential benefits (e.g., always connected,
healthcare information) for users. Once users have recognized these benefits, they are
likely to use and adopt smartphones. Effort Expectancy is the degree of ease associated
with users’ use of technology. Learning a new technology often takes time and effort. If
using smartphones is considered as an easy and straightforward process, users are
likely to adopt smartphones. Thus, we proposed the following four hypotheses.
H1: Social Influence (SI) has a positive influence on users’ intention to use
smartphones
H2: Facilitating Conditions (FC) has a positive influence on users’ intention to use
smartphones
H3: Performance Expectancy (PE) has a positive influence on users’ intention to use
smartphones
H4: Effort Expectancy (EE) has a positive influence on users’ intention to use
smartphones
Hypotheses Developed from IDT. Rogers [18] indicated that innovation that are
perceived by individuals as having greater relative advantage, compatibility, trialabil-
ity, observability, and less complexity will be adopted more rapidly than other inno-
vation. To further understand older adults’ intention to use smartphones, two factors
from IDT were included into our research model. As for the case of smartphones,
Observability can be defined as the degree to which smartphones are visible to potential
users. Compatibility can be seen as users’ belief in the consistency of using smart-
phones with the way they live and work. Previous research also demonstrated that the
importance of Observability and Compatibility to the adoption of new technologies
(e.g., e-banking [13]). Therefore, the following two hypotheses were proposed.
H5: Observability (OBS) has a positive influence on users’ intention to use
smartphones
H6: Compatibility (COM) has a positive influence on users’ intention to use
smartphones
Perceived Enjoyment and Price Value. Perceived Enjoyment is defined as the extent
to which the activity of using a specific system is perceived to be enjoyable in its own
right, aside from any performance consequences resulting from system use [19, 21].
Users can have fun when they are playing games, and playing music on smartphones.
Price value is another significant factor affects users’ adoption of a new technology.
Price value can be defined as consumers’ cognitive tradeoff between the perceived
benefit of the applications and the monetary cost for using them [23]. It is believed that
users are likely to adopt smartphones when the benefits of using smartphones are
perceived to be greater than the monetary cost of smartphones. Hence, we proposed the
following hypotheses.
H7: Perceived Enjoyment (PEJ) has a positive influence on users’ intention to use
smartphones
H8: Price Value (PV) has a positive influence on users’ intention to use smartphones
4 An Empirical Study with the Research Model
To understand middle aged adults’ and older adults’ use and adoption of smartphones
in China, the proposed research model and hypotheses were empirically tested using
the structural equation modeling approach.
4.1 Instrument Development

The validated instrument measures from previous research [4, 18, 21–23] were used as
the foundation to create the instrument for this study. In order to ensure that the
instrument better fit this empirical study, some minor words changes were made to
ensure easy interpretation and comprehension of the questions. For instance, wording
was modified to fit the context of use of smartphones in China. A questionnaire was
developed first in English and then translated into Chinese. Back-translation was
conducted by bilingual third party to improve the translation accuracy. The final
measurement questionnaire consisted of 24 items1. A seven point Likert scale was used
to examine participants’ responses to all items in this part.
4.2 Samples
The data for this study was collected through self-administered questionnaires in seven
provinces in China. The survey was distributed as paper-based questionnaires to
individuals from Dec 1st 2014 to Dec 30th, 2014. 359 completed questionnaires were
collected, among which 341 of them were valid questionnaires (i.e., valid respondent
rate 95 %). Among the participants, 186 of the participants were male, and 155 were
female. Moreover, 85.3 % of participants had full-time jobs, 10.3 % of participants had
part-time jobs, 4.4 % of participants had retired. In terms of age, 195 participants were
from the age group of middle aged adults, while 146 participants were from the age
group of older adults.
Further, the top three most used featured on smartphones for the age group of older
adults were: making phone calls, text messaging and instant messaging services (e.g.,
QQ, Wechat). With regard to the age group of middle aged adults, instant messaging
services, making phone calls, and websites browsing were rated as most frequently
used features on smartphones. Moreover, using social media services is more popular
1
The survey items are available at this link: http://www.idi.ntnu.no/*shanggao/maoadults.html.
456 S. Gao et al.
in the age group of middle aged adults than the age group of older adults. Further, both
the age groups have limited use of Emailing and mobile games on smartphones.
4.3 Measurement Model

The quality of the measurement model is determined by (1). Content validity,
(2). Construct reliability and (3). Discriminant validity [1]. To ensure the content
validity of our constructs, a pretest with 5 Chinese researchers in E-business was carried
out. And we found that the questionnaire was well understood by all the researchers.
To further test the reliability and validity of each construct in the research model,
the Internal Consistency of Reliability (ICR) of each construct was tested with Cron-
bach’s Alpha coefficient. As a result, for the age group of middle aged adults, the
Cronbach’s Alpha values range from 0.71 to 0.93. With regard to the age group of
older adults, the Cronbach’s Alpha values range from 0.82 to 0.94. A score of 0.7 is
marked as an acceptable reliability coefficient for Cronbach’s Alpha [17]. All the
constructs in the research model for both the age groups were above 0.70. Conse-
quently, the scales were deemed acceptable to continue.
Convergent validity was assessed through composite reliability (CR) and the
average variance extracted (AVE). Bagozzi and Yi [2] proposed the following three
measurement criteria: factor loadings for all items should exceed 0.5, the CR should
exceed 0.7, and the AVE of each construct should exceed 0.5. As shown in Tables 1
and 2, all constructs were in acceptable ranges for the age group of middle aged adults
and the age group of older adults respectively.
The measurements of discriminant validity for both the age groups were presented
in Tables 3 and 4. According to the results, the variances extracted by the constructs
were more than the squared correlations among variables. The fact revealed that
constructs were empirically distinct for both the age groups. As good results for
convergent validity and discriminant validity were achieved, the test result of the
measurement model was good.
4.4 Structural Model and Hypotheses Testing

The structural model was tested using SmartPLS. Table 5 presents the path coefficients,
which are standardized regression coefficients. For the age group of middle aged adults,
observability, compatibility and perceived enjoyment (H5, H6, H7) were found to have
a statistically significant effect on users’ intention to use smart phones, while the other
hypotheses were not supported. For the age group of older adults, five (H1, H3, H5,
H6, H7) of the proposed eight hypotheses were supported.
The R2 (R square) denotes to coefficient of determination. It provides a measure of
how well future outcomes are likely to be predicted by the model, the amount of
variability of a given construct. In our analysis, the R2 coefficient of determination is a
statistical measure of how well the regression coefficients approximate the real data
point. According to the result, for the middle aged adults, 58 % of the variance of
behavior intention can be explained by the research model. With respect to the older
adults, the research model manages to explain 78 % of the variable in the values of
Table 1. Factor loadings, composite reliability, and AVE for each construct (for the age group
of middle aged adults).
Construct Item Factor loading Composite reliability AVE Cronbach’s
Alpha
SI SI1 0.90 0.87 0.78 0.71
SI2 0.86
FC FC1 0.81 0.86 0.61 0.78
FC2 0.78
FC4 0.81
FC4 0.71
PE PE1 0.78 0.88 0.70 0.79
PE2 0.87
PE3 0.60
EE EE1 0.89 0.93 0.82 0.89
EE2 0.93
EE3 0.89
OBS OBS1 0.92 0.91 0.84 0.81
OBS2 0.92
COM COM1 0.93 0.95 0.86 0.92
COM2 0.95
COM3 0.90
PEJ PEJ1 0.94 0.94 0.88 0.87
PEJ2 0.94
PV PV1 0.91 0.95 0.88 0.93
PV2 0.95
PV3 0.95
IU IU1 0.91 0.90 0.81 0.77
IU2 0.90
intention to use. The results revealed that the predicative strength of the research model
for both the age groups was quite strong. Focusing on the two different age groups, the
research model had a stronger predicative strength for the age group of older adults
than the age group of middle aged adults.
5 Discussion
In this research, we studied the adoption of smartphones between middle aged adults
and older adults in China. From an academic perspective, this research contributed to
the literature on the adoption of smartphones with middle aged adults and older adults
in China by building upon previous technology diffusion theories. From a practical
perspective, it offered some insights for smartphones providers and mobile services
providers to promote the use of smartphones to different age groups in China.
458 S. Gao et al.
Table 2. Factor loadings, composite reliability, and AVE for each construct (for the age group
of older adults).
Construct Item Factor loading Composite reliability AVE Cronbach’s
Alpha
SI SI1 0.93 0.92 0.85 0.82
SI2 0.91
FC FC1 0.87 0.91 0.73 0.87
FC2 0.83
FC4 0.90
FC4 0.81
PE PE1 0.89 0.91 0.77 0.85
PE2 0.93
PE3 0.80
EE EE1 0.94 0.95 0.87 0.92
EE2 0.94
EE3 0.91
OBS OBS1 0.93 0.93 0.88 0.86
OBS2 0.94
COM COM1 0.93 0.94 0.85 0.91
COM2 0.94
COM3 0.89
PEJ PEJ1 0.94 0.94 0.90 0.88
PEJ2 0.95
PV PV1 0.83 0.93 0.81 0.89
PV2 0.94
PV3 0.92
IU IU1 0.97 0.97 0.94 0.94
IU2 0.97
Table 3. Discriminant validity (for the age group of middle aged adults)
Variables PEJ PV PE FC SI EE OBS COM IU
PEJ 0.94
PV 0.50 0.94
PE 0.63 0.48 0.84
FC 0.57 0.59 0.71 0.78
SI 0.62 0.58 0.60 0.60 0.88
EE 0.47 0.51 0.38 0.56 0.38 0.91
OBS 0.41 0.18 0.40 0.39 0.36 0.50 0.92
COM 0.61 0.56 0.67 0.64 0.67 0.49 0.40 0.93
IU 0.66 0.44 0.56 0.56 0.50 0.51 0.53 0.63 0.90
Table 4. Discriminant validity (for the age group of older adults)

Variables PEJ PV PE FC SI EE OBS COM IU
PEJ 0.95
PV 0.46 0.90
PE 0.48 0.31 0.88
FC 0.51 0.42 0.51 0.85
SI 0.56 0.57 0.51 0.69 0.92
EE 0.54 0.44 0.34 0.44 0.48 0.93
OBS 0.49 0.25 0.33 0.34 0.32 0.37 0.94
COM 0.62 0.47 0.59 0.55 0.70 0.57 0.30 0.92
IU 0.82 0.42 0.60 0.56 0.64 0.45 0.52 0.68 0.97
Note: Diagonals represent the average variance extracted, while the other matrix entries represent
the squared correlations.
Table 5. Test of hypotheses based on path coefficient for both the age groups
Hypothesis Path coefficient and their
significance
Middle aged adults Older adults
H1 −0.090 0.161*
H2 0.093 0.008
H3 0.018 0.154*
H4 0.049 −0.106
H5 0.237* 0.135*
H6 0.248* 0.168*
H7 0.362*** 0.561***
H8 0.047 −0.050
*p < 0.05; **p < 0.01; *** p < 0.001
The findings suggested that perceived enjoyment, observability, and compatibility

proved to be important determinants for the adoption of smartphones with both middle
aged adults and older adults. The most important determinant for both the age groups’
intention to use smartphones was perceived enjoyment. If using smartphones is fun,
both middle aged adults and older adults are more likely to accept smartphones. It
highlighted the role that hedonic aspects play in the adoption of smartphones by both
the age groups.
The findings also identified age-related differences in the use and adoption of
smartphones. The effects of both performance expectancy and social influence on
users’ intention to use smartphones were significant for older adults, but insignificant
for middle aged adults. Most middle aged adults tended to use features like voice phone
calls, instant messaging services on their smartphones. They might use these features
with basic mobile phones before. However, the advanced features (e.g., Emailing,
document processing) on smartphones were less used by middle aged adults. They
might be able to use email services on smartphones but chose not to because they did
460 S. Gao et al.
not want to change their habits. Consequently, they might not perceive the potential
benefits provided by smartphones. For them, the costs of changing their habits may
limit the adoption of smartphones. Therefore, the presence of the performance
expectancy did not motivate older adults to use smartphones. In contrast, some older
adults might not use basic mobile phones before. They found using basic features on
their smartphones useful for their work and life. Thus, Performance expectancy had a
significant positive impact on older adults’ intention to use smartphones. Furthermore,
middle aged adults appeared to have higher levels of self-recognition of new tech-
nologies than older adults. As a result, middle aged adults tended to decide for
themselves whether to adopt smartphones without being influenced by those around
them. Therefore, social influence did not have a significant positive impact on middle
aged adults’ intention to use smartphones.
There was no significant positive impact of facilitating conditions on the intention
to use smartphones with both the age groups. One possible reason was that facilitating
conditions might be considered as a limiting factor when the needed facilitating con-
ditions are not perceived by them. Therefore, the presence of the facilitating conditions
did not motivate them to use smartphones. Effort expectancy did not have a strong
positive influence on both the age groups’ intention to use smartphones. It seemed that
they did not use smartphones just because it was easy to use, but rather because they
found it fun to use. Another interesting finding was that price value had no significant
positive impact on the intention to use smartphones with both the age groups. Since
Chinese’ economy is growing fast and smartphones has become inexpensive in China,
most participants in this study can afford smartphones. It appeared that price value of
smartphones became unimportant when it came to the adoption of smartphones with
middle aged adults and older adults in China.
However, we were also aware of some limitations. Firstly, we only tested the
research model and research hypotheses with samples from seven provinces in China.
This sample might not be fully representative of the entire middle aged adults and older
adults in China. Secondly, all the data were collected using self-reported scales in the
research. This may lead to some caution because common method variance may
account for some of the results that has been cited as one of the stronger criticisms of
tests of theories with TAM and TAM-extended research [14]. However, our data
analysis with convergent and discriminant validity does not support the presence of a
strong common methods factor.
6 Conclusion and Future Research
This research was designed to study the differences in adoption of smartphones

between middle aged adults and older adults in China. Since China is experiencing an
increase in the average age of their population, the understanding on how middle aged
adults and older adults use and adopt smartphones is important to increase their quality
of life. The key contributions of this study are threefold. First, this study investigated
middle aged adults’ and older adults’ adoption of smartphones by extending UTAUT
with a consideration of observability and compatibility from IDT, and perceived
enjoyment and price value. Second, the findings indicated that the effects of perceived
enjoyment, compatibility, and observability on users’ intention to use smartphones

were significant, but no age differences between middle aged adults and older adults
were found to exist. Third, the effects of performance expectancy and social influence
on users’ intention to use smartphones were moderated by age, such that it was sig-
nificant for older adults but insignificant for middle aged adults. The results demon-
strated that there was a difference between the two different age groups in China.
Continuing with this stream of research, we plan to further examine the applica-
bility of the research model with other group of users in China (e.g., people below 35
years old). Future research is also needed to carry out a comparative study with middle
aged adults and older adults in other countries.
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Ease-of-Use of Tactile Interaction for Novice Older Adults
Lilian Genaro Motti1 ✉ , Nadine Vigouroux1, and Philippe Gorce2

( )
1
UPS, IRIT, University of Toulouse, 118 Route de Narbonne, 31062 Toulouse, France
{genaro,vigourou}@irit.fr
2
HandiBio, University of Toulon, Avenue de l’université, 83957 Toulon, France
[email protected]
Abstract. Usability, particularly ease-of-use, is a main factor affecting the

acceptance of technologies by older adults. Mobile devices offer great possibili‐
ties for well-being applications, but they are often equipped with touchscreen. In
order to evaluate the ease-of-use of tactile interaction, this study compares the
performances of 16 novice (mean age 74) and 8 experienced older adults (mean
75) during the execution of drag-and-drop interaction for achieving tactile puzzle
games on smartphone and tablet, with pen and fingers. Results show that novice
users were able accomplish interaction accurately with longer times but no
significant difference of errors of accuracy.
Keywords: Human-computer interaction · Interaction techniques · Older adults ·

Touchscreen · Drag-and-drop · Errors of accuracy · Ease-of-use · Usability
1 Introduction
Mobile devices offer great possibilities for well-being applications destined to older
populations. Mobile technologies are also being developed to help older users to over‐
come age related declines in cognitive, motor and perceptual skills. Unfortunately, the
adoption of technologies by this population is very limited [1]. In France, the availability
of touchscreen mobile devices in the market and the reduction of the cost for devices
and services (i.e. subscription for mobile connections) have a great impact on the number
of elderly using mobile Internet: 16.4 % of people aged 60 to 74 years old and 3.1 % of
people aged 75 years old or older in the end of 2012 according to a report of INSEE
(National Institute of Statistics and Economics Studies) [2]. They are still a small part
of the population when compared to the younger age groups: 75 % of 15 to 29 years old
or 50.8 % of 30 to 44 years old people. In Europe, 42 % of people aged 55 to 74 years
old declared a regular internet use (against 93 % of 16 to 24 or 78 % of 25 to 54 years
old) but only 12 % of this population used mobile devices for internet access (against
58 % of 16 to 24 or 36 % of 25 to 54 years old) [3].
Barnard et al. (2013) [1] defined two stages for technology acceptance: first, the
intention to use, referring to a behavior that is affected by performance expectancy,
effort expectancy, social influence and facilitating conditions; second, the usability, i.e.
“the effectiveness, efficiency and satisfaction with which specified users achieve speci‐
fied goals in particular environments” (ISO 9241). According to Lee and Coughlin

DOI: 10.1007/978-3-319-20892-3_45
464 L.G. Motti et al.
(2014), enhancing usability means to meet older adults’ needs, preventing errors and
providing help to control [4]. They describe usability as “ease of learning and use” [4].
Renaud and van Bijon (2008) consider ease of use a determining factor for intention to
use and consequently for technology acceptance among older adults [5].
Mobile devices are often equipped with touchscreen. But is tactile interaction easy
to use by older adults? The aim of this study is to evaluate the ease-of-use of tactile
interaction. Previous studies on human-computer interaction have discussed about the
effects of prior experience on older adults performances [6]. So we compare the perform‐
ances (time and error rate) of older adults with and without previous experience with
touchscreen devices. Our main hypothesis is that tactile interaction is easy to use.
Therefore, we expect that novices and experienced subjects would have similar perform‐
ances during the drag-and-drop interaction for solving tactile puzzles on smartphone
and tablet, with pen and fingers.
The remainder of this paper is organized as follows. Section 2 discuss usability as a
determining factor for technology acceptance and the ease of use of tactile interaction
for novice older adults, positioning this work in relation to the previous studies and
justifying the need of studying and improving tactile interaction. Section 3 describes the
experience. Section 4 shows the results of the statistical analysis. Results are discussed
on Sect. 5 followed by conclusions on Sect. 6.
2 Related Work
2.1 Technology Acceptance for Older Adults
Acceptance has been defined as an attitude towards technologies, referring to early phase
and essential step to an adoption process. Adoption is the process by which users
embrace technologies, since the moment when potential users become interested to a
technology until the moment the use of it has an impact in their daily lives [5].
Ease-of-use is one of the main factors of technology acceptance according to several
authors. In a review of the literature, Peek et al. (2014) found that low ease of use is a
key concern during pre-implementation acceptance factors of technologies for aging in
place [7]. According to Lee and Coughlin (2014), “ease of learning and use” is one of
the ten factors facilitating or determining the adoption of technology by this group of
users [4]. Ease of learning and use has been considered a predictor for technology
acceptance or rejection by Renaud and van Bijon (2008) [5].
Older adults are a heterogeneous population. Chronological age is not enough for
describing the characteristics of adults aged 65 years old or more because aging is an
individual process [8]. In addition to the physical and cognitive declines related to age,
earlier experiences can affect older adults perception of their own ability to use new
technologies [8]. Gudur et al. (2013) have demonstrated that previous experience with
computers and technologies affects positively the self-confidence of older adults for
interaction tasks [9]. By consequence, previous experience affects their attitudes and
expectations towards technologies or even acceptance [1]. Older adults who did not learn
how to use a computer during their professional carrier or education need more training
to progress and feel confident compared to younger adults [1]. Technologies, interfaces
Ease-of-Use of Tactile Interaction for Novice Older Adults 465
and interaction techniques should be easy to learn and use in order to overcome lower
technology literacy [4].
2.2 Ease-of-Use of Tactile Interaction for Novice Older Adults

Tactile interaction is considered easy to learn and use because direct interaction on the
screen reduces the cognitive workload demanding less eye-control coordination than
traditional input devices [10]. Direct interaction on touchscreen has been recommended
for older adults as easier to use [10], reducing the gap of performances between adults
and older adults when compared to traditional input devices [11].
When using new technologies, people might feel uncomfortable if they don’t know
how to control it [12]. Anxiety is related to lack of confidence and this feeling can affect
the perceived benefit [4], disturbing the use of intuitive interaction. It also affects older
user’s performances because it causes distraction. The absence of physical keyboard
and mouse diminishes the anxiety towards technologies, affecting positively user’s atti‐
tudes [10]. Familiarity with the interaction and interfaces influences the attitudes towards
technologies [4]. Systems and interaction techniques designed to prevent mistakes and
support interaction help to increase confidence [9].
2.3 Difficulties Related to Tactile Interaction
8 % of French users, all age groups included, complained about difficulties for using tactile
interaction [2]. Older users have reported several problems during touchscreen use as
discouraging for the acceptance of technologies and disturbing for achieving interaction,
such as lack of control, small targets, difficulties for error recovering among others.
The review of the literature of studies of tactile interaction of older adults describes
problems related to the situations of use or users’ abilities.
Concerning the situations of use, several factors have been reported. Small screen
devices usually present small targets, difficult to acquire, especially during finger inter‐
action [13]. Pen interaction has been indicated to improve accuracy, especially on small
touchscreen devices [14]. Concerning the gestures of interaction that have been evalu‐
ated, tapping has been considered intuitive and faster than dragging [11, 15] but it
requires bigger targets. Drag-and-drop allows accurate interaction on small devices [14]
and performances increase rapidly with practice [15].
Concerning the abilities of older users, visually impaired users were able to accom‐
plish drag-and-drop interaction during card games on mobile devices [6]. This gesture
of interaction has been studied to improve text entry tasks for older users with tremor
[16, 17]. During mouse interaction, dragging elements helps to track the cursor on the
screen and it has been evaluated for cognitive impaired users [18]. The metaphor of drag
interaction gesture is closer to the reality.
Familiar and ludic activities help novice users to discover the manipulation of
devices and learning interaction [19]. When playing a game, an error is not supposed to
be serious and discouraging because it doesn’t have implications on real life. That is one
of the reasons the present study evaluates tactile interaction during the execution of
puzzle games.
3 Methods
Ease-of-use is one of the main factors of usability affecting technology acceptance [4, 7].
As mobile devices are often equipped with touchscreen, we want to investigate if tactile
interaction is easy to use. As already presented in the Sect. 2, previous experience with
technologies affects users’ performances. So we will compare two groups of subjects:
older adults with and without previous experience with touchscreen. Our hypothesis is
that novice and experienced older adults will have similar performances.
HCI studies usually assess interaction performances through time and error rate. In
order to reproduce different situations of use of mobile touchscreen, we will evaluate
performances on smartphone and tablet, with pen and fingers and two levels of difficulty
(corresponding to two accuracy requirements). The easier level requires 80 % of accu‐
racy and the higher level requires 95 % of accuracy for the final positioning. These two
levels will be treated indistinctly. As a complement, we will search for effects of screen
size and interaction techniques. This study extends the analysis of a previous study about
supplementary attempts for positioning the targets [14].
3.1 The Interactive System
The system “Puzzle Touch” is consisted of tactile puzzle games so older adults without
previous experience with touchscreen would feel confident to participate of the experi‐
ence by the familiarity with the proposed activity [19].
The main task is moving the puzzle pieces to place them on a grid (drag-and-drop).
Targets sizes (the correct emplacement for a puzzle piece) were 19 × 19 mm on the
smartphone (85 pixels width) and 35 × 35 mm (195 pixels width) on the tablet. 12
squared pieces are randomly placed on the mid bottom of the screen and a 3 × 4 grid
with a watermark is displayed on the mid top. In order to compensate the lack of spacing
between pieces, they are contoured by a 1 mm dark border. When the final position of
a puzzle piece is validated, there is a visual feedback (a flash effect) and the piece is
fixed on the grid.
3.2 Material
A 5.5 inches screen smartphone (Galaxy Note II with a WXGA 1280 × 720 Super
AMOLED touchscreen) and a 10.1 inches screen tablet (Galaxy Note 10.1 with a WXGA
1280 × 800 LCD touchscreen) were used for this experiment. Both devices allow inter‐
action with pen or fingers.
3.3 Procedure
Recruitment took place on associations, clubs and libraries frequented by older adults
in Toulouse, France, where demonstration meetings were organized to explain the
purposes of the study. Being aged 65 or older was the unique criteria of inclusion.
Volunteers had an individual appointment for the experiment.
The individual session started by a familiarization phase with at least four complete
interactions with both interaction techniques on the tablet and on the smartphone. After
given their formal consent, they passed eyesight control tests and answered question‐
naires about their motor abilities, previous experience with technologies and particularly
frequency of use of touchscreen devices.
Subjects were told to install themselves comfortably, they were seated and the
devices were horizontally placed on a table on portrait mode. Participants were told to
complete the games accurately. Every subject played eight tactile puzzle games: with
pen and finger interaction, on smartphone and tablet and two sets on different require‐
ment levels (first the easier level, requiring 80 % accuracy, and then the difficult one,
requiring 95 % of accuracy). The order of the use of devices and interaction techniques
has been counter-balanced.
3.4 Measures
We assessed mean time of movement and number of errors of accuracy as evaluation
criteria.
Time of movement refers to the time the subject spent moving the pieces before
reaching their correspondent target (TM). It does not include reflection time.
The number of errors of accuracy was verified according to the position of the
dropped piece on the game. One error of accuracy is counted once the puzzle piece is
covering at least 50 % of its right emplacement but should be corrected positioned to
meet the accuracy requirements of the game. The others movements of the puzzle pieces
have been considered as a strategy to solve the puzzle. The number of errors of accuracy
(EA) [14] counts the number of supplementary attempts for reaching a target.
4 Results
4.1 Participants
24 body-abled older users (range 65–86, mean 74.25, SD = 5.8) participated of the
experience. User profiles were defined according to the information reported on the
initial questionnaire: 8 of them had previous experience and regular use of touchscreen
devices. Subjects have been divided into two groups:
• Group A includes 8 subjects who use touchscreen at least once a week (mean age
74.75, SD = 6.79), 4 of them use a smartphone and the other 4 use a tablet, all use
finger interaction;
• Group B includes 16 novice subjects (mean 74, SD = 5.06) who had never or rarely
use touchscreen devices before the experiment.
4.2 Statistical Analysis
Data is not normally distributed according to the results of Shapiro Wilk test (TM:
W = 0.8788, p-value = 2.592e-11; EA: W = 0.7886, p-value = 2.202e-15). By
consequence, Mann Whitney U test has been used to evaluate significant effects of
user’s profiles (Group A and Group B).
Data of each group of subjects is not normally distributed neither according to the
results of Shapiro Wilk test: Group A (TM: W = 0.9518, p-value = 0.01409;
EA: = 0.8462, p-value = 0.0003436) or Group B (TM: W = 0.8635, p-value = 1.68e-09;
EA: W = 0.9189, p-value = 0.0004455).
Data distribution for TM and EA is skewed left. For this reason we detailed median
for the tendencies and inter-quartiles (IQR) for the variability.
Friedman test has been used to search for significant differences between the four
situations of the study (smartphone or tablet, pen or finger). For the post hoc analysis,
the Wilcoxon signed rank test has been used to evaluate screen size or interaction tech‐
niques effects. In this case, a Bonferroni correction has been applied, setting the p-value
to 0.0125.
4.3 Time of Movement

The statistical analysis show that there is a significant difference of experience of use of
touchscreen on time of movement (TM) (Z = 10.51528, W = 5205.5, p-value = 0.002249).
The mean time for Group A is 28.3 s (SD = 13, median = 27.2, IQR = 16.5) and for Group
B it is 37.5 s (SD = 19.8, median = 30.9, IQR = 19.3). There is a bigger variability among
novice users, as observed on Fig. 1.
Fig. 1. Time of movement (TM) for experienced (Group A) and novices (Group B)
There is a significant effect of the different situations (screen sizes, interaction techni‐
ques) of the game on TM for all subjects (chi-squared = 75.8, df = 23, p-value =
1.499e-07), as well as for Group A (chi-squared = 21.5, df = 7, p-value = 0.003096) and
for Group B (chi-squared = 50.3382, df = 15, p-value = 1.06e-05). Consequently, we
search for effects of interaction techniques and screen sizes.
No significant effect of interaction techniques was found for Group A

(Z = 1.869894, V = 364, p-value = 0.06222) neither for Group B (Z = 1.123501,
V = 1208, p-value = 0.2626). There was no significant effect of the screen sizes for
Group A (Z = −2.262572, V = 143, p-value = 0.02279). But there is a significant
effect of screen sizes for Group B (Z = −3.203315, V = 561, p-value = 0.001374).
On average, they spent 34.7 s (SD = 18.7, median = 29.6, IQR = 18.1) during inter‐
action on smartphone and 40.3 s (SD = 20.6, median = 31.6, IQR = 18.2) on tablet.
The shortest TMs for Group A and for Group B were executed during pen interaction
on smartphone (Group A: mean 24.4, SD = 7.9, median = 23.8, IQR = 4.8 and Group
B: mean 34.9, SD = 17.4, median = 27, IQR = 21.9). No significant difference between
the two groups was found for any situation, details are presented on Fig. 2.
Fig. 2. Time of movement (TM) for experienced (Group A) and novices (Group B) during the
different situations of the experience (Smartphone or Tablet with Finger or Pen).
4.4 Errors
There is no significant difference of experience of use of touchscreen on number of

errors of accuracy (EA) (Z = 7.595485, W = 4406.5, p-value = 0.3922) as presented
on Fig. 3. Mean EA for Group A is 10.5 (SD = 12.6, median = 5.5, IQR = 11.3) and
for Group B is 12.4 (SD = 14.1, median = 6, IQR = 14.3).
There is a significant effect of the different situations of the game on EA for all
subjects (chi-squared = 70.484, df = 23, p-value = 1.024e-06) as well as for Group A
(chi-squared = 20.5945, df = 7, p-value = 0.004419) and for Group B (chi-
squared = 44.9778, df = 15, p-value = 7.719e-05). Consequently, we search for effects
of interaction techniques and screen sizes.
There are significant effects of interaction techniques (Z = 0.5796671, V = 295,
p-value = 0.01105) and screen sizes (Z = 1.76705, V = 358.5, p-value = 0.009706)
on EA for Group A. Experienced subjects made more errors of accuracy during
interaction with finger (mean = 12.3, SD = 15, median = 6.5, IQR = 13) than with
Fig. 3. Errors of accuracy (EA) for experienced (Group A) and novices (Group B)
pen (mean = 8.7, SD = 9.6, median = 5, IQR = 12). Errors of accuracy were more
frequent on smartphone (mean = 13.2, SD = 14.3, median = 8.5, IQR = 19) than on
tablet (mean = 7.8, SD = 10.2, median = 5, IQR = 6.3).
There is a significant effect of interaction technique (Z = 0.4748128, V = 1111,
p-value = 0.01069) on EA for Group B but no effect was found for screen sizes
(Z = 0.7055317, V = 1145.5, p-value = 0.04944). Novice subjects made more errors
of accuracy during interaction with finger (mean = 14.1, SD = 14.7, median = 7.5,
IQR = 15.3) than with pen (mean = 10.7, SD = 13.4, median = 5, IQR = 13.3).
Pen interaction on tablet was the most accurate situation for novices and experienced
subjects. The number of EA for Group A was on average 6.25 (SD = 5.7, median = 5,
IQR = 7.3) and for Group B it was 8.9 (SD12.4, median = 4.5, IQR = 9.3). The less
accurate situation for both groups was finger interaction on smartphone, where average
EA for Group A was 15.2 (SD = 16.3, median = 10, IQR = 18.8) and 15.4 for Group
B (SD = 16.4, median = 7, IQR = 17.5). No significant effect of touchscreen experience
was found for any situation, details are presented on Fig. 4.
5 Discussion
Novice and experienced subjects were able to complete the tactile puzzle games. Appa‐
rently, the familiarity with the task and the metaphor of drag-and-drop helped older
adults with and without experience with touchscreen devices to accomplish the inter‐
action on smartphone and tablet, with pen and finger.
The statistical analysis shows that there is a significant difference between the two
groups of users on time of movement. Novice older adults spent longer times. There is
a significant effect of screen sizes on time of movement only for novice users; they spent
less time during interaction on smartphone, where the distances are smaller. The shortest
time for both groups was executed during pen interaction on smartphone.
Fig. 4. Errors of accuracy (EA) for experienced (Group A) and novices (Group B) during the
different situations of the experience (Smartphone or Tablet with Finger or Pen).
There is no significant difference of use of touchscreen on number of errors of

accuracy. There is a bigger variability among novice subjects. A significant effect
of interaction technique was found for both groups. They made fewer errors during
pen interaction. Effects of screen size were found only for experienced subjects, who
were more accurate during interaction on tablet.
Our main hypothesis is partially confirmed: novice spent longer movement times but
novice and experienced older adults have similar number of errors on global results.
However, some situations of the experience seem to facilitate the interaction for novice
subjects. Pen interaction reduced time and error rates for this group. Other studies about
tactile interaction of older adults demonstrated that older subjects take longer times but
they are not less accurate than younger users [20], who have prior experience with tech‐
nologies. Maybe using a pen is more natural for novice users. Generally subjects made
more errors of placement during finger interaction but the difference is really small for
experienced users. As already reported by previous studies about tactile interaction of
older adults, the fingertip and the hand can occlude a part of the screen [11]. Experienced
subjects would know how to adapt the gesture to avoid errors of accuracy during finger
interaction since there are used to interact with fingers. Bigger screen sizes have also
been recommended for older adults as bigger targets are easier to acquire [15], even if
distances are bigger and so are the deviations [20].
Previous studies evaluating drag-and-drop have demonstrated higher accuracy for
this interaction gesture, even if it takes longer times than tapping [11, 16]. Sliding the
finger on the screen can increase the confidence of older users because they can better
anticipate the acquisition of the targets. Errors of interaction increase considerably the
cognitive workload for older users, especially novices who will need to create a strategy
for recovering. Errors of accuracy as slipping or missing a target can have severe conse‐
quences. For example, missing a target during text entry tasks can cause insertion of
characters and more interaction is necessary to correct the word [21]. In addition to that,
supplementary manipulation can trigger other errors. For this reason, it is important to
evaluate and prevent errors of accuracy during interaction.
Even if subjects were body-abled, aging related changes can affect user’s skills, what
could explain the variability of performances. Further studies should evaluate the effects
of different user’ profiles on interaction such as age, education, use of technologies,
eyesight and dexterity. A future work for the analysis of ease-of-use of touchscreen
should provide a deeper understanding of appropriation of tactile interaction after a
longer period of practice or several iterations.
The results demonstrate that drag-and-drop interaction on mobile touchscreen devices
is easy to use, confirming previous considerations about the usability of touchscreen for
older adults. Potential users consider the ease-of-use for accepting a technology and this
factor should persist during the adoption process [22]. Hence, we propose that tactile inter‐
action continuous to be improved and applied on technologies for aging people. In the
other hand, as touchscreen seems to be usable for older populations, the problem of limited
acceptance and adoption of technologies need to be redressed through other factors. For
example, the familiarity of the interfaces and interactions could reduce anxiety for novice
users. Adaptive visual displays could also be used to improve the accessibility and reduce
error rates. As younger populations have adopted mobile devices, we expect that tactile
interaction will be adapted to respond to their needs for a longtime.
6 Conclusion
This study evaluated the ease-of-use of touchscreens by the comparison of novice and
experienced older adults. Time of movement and the number of errors of accuracy were
assessed during drag-and-drop interaction for achieving tactile puzzle games.
Results show that novice older adults were able to accomplish tactile interaction with
longer movement times but not significant difference of error rates when compared to
experienced older users. Tactile interaction can be considered ease to use but should be
improved to allow older adults to adopt and use technologies for longer times. Familiar
tasks and coherent metaphor for the gesture of interaction can help novice users to better
understand and learn interaction. These factors could be used to redress the limitation
of acceptance of technologies by older populations. Improving accessibility and
usability is necessary to allow older populations to continuously access the benefits of
mobile technologies and to prevent digital exclusion.
Acknowledgements. Phd Scholarship Ciência sem fronteiras, CNPQ, Brazil (#237079/2012-7).

We kindly thank all the participants and the seniors associations in Toulouse, France, that helped
us during the recruitment phase.
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Age-Related Differences in a Usability Study
Measuring Accuracy, Efficiency, and User
Satisfaction in Using Smartphones for Census
Enumeration: Fiction or Reality?
Erica Olmsted-Hawala(&) and Temika Holland
Center for Survey Measurement, U.S. Census Bureau, 4600 Silver Hill Road,
Washington DC, WA 20233, USA
{Erica.L.Olmsted.Hawala,Temika.Holland}@census.gov
Abstract. Age-related differences were investigated in a usability study of an

application developed for U.S. Census Bureau enumerators to collect survey
data and automate their time and expenses. Accuracy, efficiency and satisfaction
measures were collected as participants used a smartphone to answer typical
tasks. Usability flaws were also identified with the application. Results indicate
that in general there were no differences with task accuracy and efficiency when
comparing all tasks, however when looking at individual tasks, the task that had
the most usability flaws also revealed age-related differences for accuracy and
efficiency – that is older adults were less accurate and took longer to complete.
Surprisingly, there were age-related differences with the user satisfaction of the
application such that older adults were less satisfied with the application than
younger adults. Tying age-related differences to usability flaws highlights the
importance of designing optimal applications for all users.
Keywords: Usability Accuracy Efficiency Satisfaction Age-related dif-

ferences NRFU Census bureau
1 Introduction
Every ten years, the U.S. Census Bureau conducts a mandatory census of the population.
Households are encouraged to self respond, either by answering survey questions on
paper and mailing the survey back, or, for the 2020 Census, answering the survey online
using the Internet. However, for the households that do not respond, the Census Bureau
must send a census employee (enumerator) to their door so that the household has the
opportunity to answer the survey questions in person. This operation is called the
Non-Response Follow Up or NRFU. The NRFU operation is a massive undertaking and
in preparation for the NRFU, the Census Bureau employs temporary workers as enu-
merators. The enumerators are diverse in age, ranging from recent college graduates to
Disclaimer: This report is released to inform interested parties of research and to encourage
discussion. Any views expressed on the methodological issues are those of the authors and not
necessarily those of the U.S. Census Bureau.
© International Copyright, 2015, U.S. Department of Commerce, U.S. Government

DOI: 10.1007/978-3-319-20892-3_46
476 E. Olmsted-Hawala and T. Holland
retirees. In fact, for the 2010 Census, 13 percent of all enumerators were over the age of
65. Forty-six percent were between the ages of 40 and 65 while 41 percent were 39 years
old or younger [1]. All the enumerators for the 2010 Census conducted the NRFU on
paper. However, for the 2020 Census, the business plan is to use small mobile devices
(e.g., smartphones) to conduct census activities. Consequently, the software application
that is created for mobile devices to aid the job of the enumerator must be suitable to
enumerators of differing ages and with various levels of experience in use of smartphones.
One such prototype application under development for the 2020 Census is the
Census Operations Mobile Platform for Adaptive Services and Solutions (COMPASS).
COMPASS serves as an enumeration platform for conducting such activities as
collecting survey data, case management, location aids, security services, and new
modules that included automating time and expenses. The development team had not
tested the new functionality with users and were interested in obtaining usability
feedback on the new features of the COMPASS. In addition, the team was interested
in identifying any usability issues that might exist in the application, including case
management and icon usage on the screens.
This paper presents the results of a quantitative and qualitative usability study that
investigated user behavior of effectiveness, efficiency, and satisfaction [2, 3] when
using the COMPASS application.
The primary goal for the study was to identify usability issues of the application.
We also wanted to get a better understanding of any performance differences among
older and younger adult smartphone users. We hypothesized that (1) for the simple
tasks, older adults and younger adults would be equally accurate in performance. The
rationale for this was that when the task is simple, both age groups will perform with
few difficulties. That is, on simple tasks, both younger and older adults will be able to
complete the tasks effectively. For the complex tasks we hypothesized that (2) age and
experience would come into play such that younger and older adults that were highly
experienced with smartphones will perform with less difficulties, while, older adults
with low to moderate experience on smartphones will have more difficulties. We
further hypothesized that (3) older adults would take longer to complete the tasks. The
rationale for this was twofold, older adults act slower due to, first, cognitive decline,
e.g., Loos [4, 5] and Loos and Romano [6]; and second, the speed/accuracy trade off
among older adults [7–10]. Finally we hypothesized that (4) there would be no
age-related differences with respect to satisfaction. The rationale for this was that while
intuitively it appears that satisfaction should be impacted by performance and effi-
ciency, as we have seen in prior usability studies satisfaction rates have not been found
to differ by age even when accuracy or efficiency scores did [11, 12].
2 Methods
2.1 Tasks
Participants in the usability study completed seven tasks using the COMPASS applica-
tion. These tasks consisted of typical tasks that Census enumerators need to do to conduct
census activities. Task difficulty was equivalent to what enumerators would do in the field
Age-Related Differences in a Usability Study Measuring Accuracy, Efficiency, and User 477
– and when initially constructing the tasks, they all appeared to be, in general, of simple
cognitive complexity. These included activities such as listing the enumerators’ weekly
work availability, entering their hours worked, and expenses such as tolls, and completing
sample enumeration cases that targeted use and understanding/use of icons within the
application. The test assessed users’ ability to perform tasks using the application and
identified any problematic design features. See Appendix A for a list of the tasks.
2.2 Task Complexity

When initially planning the test, we intended tasks to be of the same complexity. While
running participants through the usability study, however, it was clear that one task
(e.g., Task 2) was proving more difficult for participants due to the usability flaws in the
design of the application. Thus we categorized Task 2 as the most difficult and most
cognitively challenging task.
2.3 Participants
Fourteen participants participated in the study: 7 younger (range 18–24) and 7 older
adults (range 50–66). We divided the participants into two age groups purposely
selecting age ranges that were far enough apart to detect age-related differences. The
participants had at least one year experience using the Internet on a smartphone (e.g.,
iPhones or Androids) such as checking e-mail, getting mapping directions, reading the
news, shopping online, using an app, etc. Nine of the participants were recruited from a
database managed by the Center for Survey Measurement. These participants resided in
the Washington DC metropolitan area and responded to a Craigslist online posting
and/or flyers put up in local community centers. Five participants were former enu-
merators that lived in the Washington DC metropolitan area and had some prior
experience in completing Census enumeration activities—however at the time of the
study they were not federal employees. Participants were compensated $40.00 for their
participation. Participant demographics are presented in Table 1.
2.4 Procedure
Usability testing was conducted at the U.S. Census Bureau’s Human Factor’s and
Usability Laboratory in Suitland, MD. The participant sat in a room facing a one-way
mirror in front of a table that had the TOBII mobile eye tracker stand with the X2-60
eye tracker mounted on it. The participant entered the testing room and was informed
about the purpose of the study and the use of data to be collected. The participant then
signed a consent form giving permission to be audio and video recorded. The partic-
ipant completed an electronic initial questionnaire about his/her smartphone use, and
demographic characteristics. After that, we calibrated the participants’ eyes for
eye-tracking purposes. The participant did a practice think-aloud task (e.g., the number
of windows in their home) and then worked on the tasks. During the session, minimal
concurrent think-aloud probing by the test administrator occurred, including such
probes as “keep talking,” and “um-hum?” After the tasks, the participant answered a
Table 1. Mean (and range) demographics by age group
Age group
Younger Older
N 7 7
Gender 2M / 5F 3M / 4F
Age 21 (18-24) 56 (50-66)
2 BA/BS 4 BA/BS
Education 5 > BA/BS 3 > BA/BS

Hours per week using
smartphone to access Inter- 17 (10-40) 12 (3-24)
net?
Experience with your
smartphone to use the 4.8 (4-5) 3.8 (3-5)
Interneta
a
Scale: 1 (None) – 5 (A great deal)
short satisfaction questionnaire to assess his/her experience using the application.

Finally, we asked the participant debriefing questions about the screens and tasks that
he/she had just worked on. During the session, the test administrator sat next to the
participant. There were two reasons for this (1) due to the application still being in
development, it could freeze up and the test administrator had to reset it. (2) The test
administrator, when necessary, re-directed the participant when he/she required
knowledge that he/she would learn in training, (e.g., during one task, participants
needed to know that when conducting an interview with a neighbor, it was considered a
“proxy visit”).
2.5 Usability Metrics

We assessed three typical usability metrics: accuracy, efficiency, and satisfaction.
Accuracy outcomes were assigned by the test administrator and were recorded as a
success (1), a fail (0), or a partial correct (0.5).
Efficiency was calculated as the total duration of the task, starting after the par-
ticipant read the task aloud and ending once the participant found the answer or said
they were ready to move onto the next task.
Satisfaction was calculated by summing nine scores from the modified version of
the QUIS [13] administered at the end of the session. Each score was on a Likert scale
from 1 to 7; so the summed score for a participant ranged from 9 to 63. The higher the
score, the more satisfied the user reported being with the site.
2.6 Analysis Methods

Due to our small sample size (N = 14) for accuracy we used the Fisher Exact Test with
the Freeman-Halton extension in order to obtain a distribution of values in a 2 × 3 table
(accuracy outcome was a categorical variable with three outcomes). Using this statistic,
we can decide whether the population distributions are identical. To compare differ-
ences between the two age groups in both efficiency and satisfaction we used the
Mann-Whitney Test because (a) small sample size and (b) we assumed the data to be
continuous but not necessarily normally distributed.
3 Results
We examined the relationship between age and accuracy using the Fisher exact test.
Across all tasks younger adults in general performed at a higher accuracy rate than
older adults. By means of the Fisher Freeman-Halton test for our 2 × 3 table the relation
between age and accuracy was significant p = 0.01. However when we tested each task
individually, there appeared to be only one task that was making the significant dif-
ference. Task 1 p = 0.71, Task 2 p = 0.01, Task 3 p = 0.56, Task 4 p = 1.0, Task 5
p = 0.23, Task 6 p = 0.71, Task 7 p = 1.0. With Task 2 we see that younger adults were
more accurate in task performance than older adults. This task was also the most
difficult for participants to accomplish due to the usability flaws in the design. Con-
sequently when we re-run the data removing Task 2, the results for all the other tasks
were not significant, p = 0.12. This indicates that for tasks that are of low cognitive
complexity, with fewer usability flaws, there appear to be no age-related differences,
while for the task that required more cognitive fluency, and had more usability vio-
lations, age-related differences are apparent.
We examined efficiency and satisfaction using the Mann-Whitney Test. In the
descriptions below Med stand for Median. For efficiency, across all tasks, again while
younger adults generally performed faster (in seconds) (Med = 168), Range (47–240)
than older adults (Med = 334) range (68-496), like in the accuracy scores, there appear
to be significant differences when looking at average time spent on all tasks Z = 1.85,
p ≤ 0.05. However, as with the accuracy score, Task 2 was driving these results. When
we look at the tasks individually, there were age-related differences only for Task 2, the
task that was most difficult to accomplish such that younger adults were faster
(Med = 168) range (99–224) at completing the task than older adults (Med = 496) range
(381–660). The result is significant Z = 3.10, p ≤ 0.001. If we look at all tasks together,
but remove the results from Task 2, there were no statistically significant differences
between the age groups with respect to efficiency, though the trend is leaning towards
significance Z = 1.60, p = 0.05.
For satisfaction, young adult participants reported being more satisfied (Med = 40,
range (36–45) with the application on the smart phone than their older adult coun-
terparts (Med = 30), range (27–33). The result is significant Z = 3.53, p = 0.0004.
4 Discussion
The accuracy results support our first hypothesis, that for simple tasks, aside from Task
2, older and younger adults do not perform significantly different from each other.
Simple tasks, such as syncing the device, work for all users. The sync task which
requires users to press on a visible and somewhat universal refresh symbol is not
complicated such that all users in our sample, even those who use the phones less
frequently are familiar with such a symbol after even a brief exposure to smartphones,
and consequently are able to accomplish this with ease. Finding no age-related
differences on simple tasks is also seen elsewhere in the literature (see also
Olmsted-Hawala, Romano Bergstrom, Rogers [14]).
As is the case with accuracy results, efficiency results are in parallel. That is for the
simple tasks, there are no age-related differences among older and younger adults when
working on simple tasks. It is only with the most difficult task (e.g., Task 2) that
age-related differences emerge with respect to efficiency. This is in contrast to our third
hypothesis that for all tasks, efficiency scores differ, such that older adults take longer.
This is also in contrast to the literature (e.g., 4–10) and warrants more investigation on
the correlation between age and task complexity on efficiency measures. However as
the p-value for efficiency overall approaches significance, the trend in this direction
indicates the possibility that with a higher sample size we would see differences. As has
been described elsewhere in the literature (e.g., Fukuda and Bubb [15]) we too find that
older adults are more vulnerable to usability flaws– such that on the most difficult task
where the user interface didn’t meet user expectations, older adults take longer and
have more difficulties in progressing successfully on the task. This is not the case for
younger adults who are able to recover when confronted with the less optimal design.
The complexity of the cognitive demands, in the end influences the speed with which
older adults are able to accomplish their task. This is consistent with the literature
(Bashore, Ridderinkhof, Molen [16]).
The ability to self-correct – e.g., make a mistake, realize it, then back up and correct
the mistake by going down the more optimal path – is crucial when working on more
complex tasks. When this occurred, if the participant was a young adult, they were able
to self-correct, while the older adult took longer to realize, or never realized that they
were in the wrong place to accomplish the task.
The issues with usability flaws and the impact associated with one’s age is
important for the design team and developers to take into consideration as they decide
what usability fixes to make and what will be postponed or put off until the next
development cycle. This is particularly important for applications that need to be
optimized for adults of varying ages.
With respect to the satisfaction results, we are surprised to find that age-related
differences do emerge. This is in contrast to the literature on usability study satisfaction
of participants’ using websites (Romano Bergstrom, Olmsted-Hawala, Jans [11]) and is
contrary to our fourth hypothesis. It is interesting that older adults reported less sat-
isfaction with the use of the application when using it on a smartphone. We speculate
that the use of a small screen compounded the frustration level such that satisfaction
differences emerged. Subjective satisfaction measures with respect to age and small
screens should be tested further.
4.1 Limitations
A caveat to these results is the small number of participants in each age group. While
usability studies in general have smaller sample sizes, typically recruiting 5 to 8, users
[17, 18] our small sample does limit the statistical analyses and generalizations we can
make of the data.
In terms of experience, we were unable to recruit older adults that had equal
experience with the younger adults on the use of smartphones. While we did have older
adults that used smartphones, they did not use them to the same extent as their younger
adult counterparts. Thus it is difficult to tease out whether older adults with the same
amount of experience would also have performed well on the more complex task (see
also Loos [4, 5] and Hill, Dickinson, Arnott, Gregor, McIver [19]). Hence in this study,
we were unable to test our second hypothesis, due to insufficient data.
It will be interesting to continue the study with additional older and younger adults
and see if the trends we find hold. In addition, it would be beneficial to have more tasks
of greater complexity as well as additional older adults with greater expertise in use of
smartphones.
Appendix A
Task 1: Your availability to work is as follows:

Wednesday (11/26) 8am to 4:30 pm for 6 h
Thursday (11/27) Unavailable
Friday (11/28) 8am to 12 pm for 3 h
Saturday (11/29) 8am to 12 pm for 3 h
Sunday (11/30) 8am to 12 pm for 3 h
Enter this information into the application.
Task 2: On last Tuesday 11/18 you ended up working from 9am to 12 pm. You
travelled to an apartment in your assignment using your own car. You drove 13
miles to visit the apartment and 13 miles back home. You also crossed the Census
Bridge, which has a toll of $3.50 each way. Enter this information into the appli-
cation and submit when complete.
Task 3: You need to do a manual sync of the data. How would you manually
synchronize the data in the application? Are there any clues as to how to do this? If
the data had actually synchronized, how would you be able to verify that the sync
completed successfully? Tell the test administrator how you would know.
Task 4: You arrive at the first address/home you’ve been assigned (first one on the
list). The respondent reluctantly agrees to a quick interview.
Please begin interview and input the following responses for each screen that you
encounter (in order): Personal Visit, Attempting address, Yes, Yes, Yes, Bob Terry
David, 555-234-5678, No, No).
You have arrived at the foster children screen and the respondent does not under-
stand the purpose of this question. He asks you what the purpose is of this question.
Find the answer to this question within the application.
Task 5: After you explain it to him, he suddenly grows agitated and abruptly ends
the interview and refuses to answer any more questions. He goes on to say what a
waste of taxpayer dollars the Census represents. No notice of visit is left as
respondent orders you off his property. Exit the interview within the application and
answer the questions that follow.
Task 6: You approach the second address/home of the day (second one on the list).
When you arrive, you notice that the house is under construction. Based on this
information, you are curious about the Contact History and Case Notes for this
address. Find the Contact History and Case Notes for this house within the
application.
Task 7: You are still at the same house as in Task #6 and you are growing more
convinced that perhaps no one lives at this address but it’s hard to tell. You then see
a neighbor pull into her driveway next door. You walk over to this woman (Tammy
Janice Hartmann, Phone number 202-555-5555, 345 ABC Road, Suitland, MD
20752) and ask her if she could answer a question or two about the house next door.
She agrees to answer a few questions and says that no one has lived there in over 6
months (which includes July 1, 2014). She mentions that the owners abandoned the
home after going way under water on their mortgage and that the bank is in the
process of selling the property. She says she gets home from work around 5 pm
each weekday and that it would be ok to call her if we have additional questions.
Enter all of this information (including her name, phone number, address and
availability) in the application.
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Older Adults and the Appropriation
and Disappropriation of Smartphones
Natalie Pang1(&), Samantha Vu2, Xue Zhang2, and Schubert Foo1

1
Wee Kim Wee School of Communication and Information, Nanyang Tech-
nological University, 50 Nanyang Avenue, 639798 Singapore, Singapore
{nlspang,sfoo}@ntu.edu.sg
2
Centre of Social Media Innovations for Communities, Nanyang Technological
University, 14 Nanyang Drive, HSS-06-15, 637332 Singapore, Singapore
{sgtvu,zhangxue}@ntu.edu.sg
Abstract. Research in recent years has focused on examining the acceptance as

well as the appropriation of technologies amongst older adults, especially in
how technologies alleviate issues of functional declines, loneliness, and financial
difficulties brought about by ageing. Yet such studies have often overlooked
meaningful appropriation or disappropriation of technologies amongst older
adults. By drawing on a longitudinal study of ten older adults who were given a
smartphone under a corporate social responsibility program by a telecommu-
nications company, we followed the use of smartphones by ten older adult users
using in-depth interviews lasting one to two hours each. Our findings revealed a
mix of appropriation and disappropriation, which are linked to everyday tech-
nological use and routines, attitudes to technology, and social support.
Keywords: Non-use Technology appropriation Older adults Smartphones
1 Introduction
Ageing brings with it related and interdependent issues such as functional declines,
loneliness, isolation, and financial difficulties. With the loss of social contacts, older
adults often find themselves facing social isolation and loneliness [1]. This may be further
compounded by their exclusion from participating in today’s technologically-oriented
and driven society. Having access to technology as well as the ability to use it has been
argued and thought to bring older adults out of isolation and ensure that they remain active
in society. Such gaps have been recognized by various societies and non-profit organi-
zations, which subsequently seek to provide access and train older adults in using
technologies in their daily lives.
As potential technological interventions, smartphones provide many opportunities
to meet the needs of older adults [2]. As handheld devices with advanced computing
capabilities, smartphones provide applications that can assist older adults in various
aspects of their lives, such as medicine adherence, lifelong learning, and assisted living
[3]. Yet certain functional declines of older adults can result in specific needs and
requirements, and many smartphones and computing devices are designed to handle
these needs.

DOI: 10.1007/978-3-319-20892-3_47
Older Adults and the Appropriation and Disappropriation of Smartphones 485
Yet despite the functionality, advances in the usability and usefulness of smart-
phones, some older adults do not use smartphones and computing devices. However,
this may not always be a simple case of non-adoption, as the findings of this study
would suggest.
2 Literature Review
Rogers [4] described technological adoption as a process “to make full use of an
innovation as the best course of action available” (p.12). Beginning with awareness and
access, it ends with the user embracing the technology and eventually using it for their
functions and value. Acceptance, on the other hand, refers to attitudes towards tech-
nology. Acceptance is closely linked to adoption: acceptance is a precondition for
adoption, and in cases where there is no acceptance, it is also unlikely for an individual
to adopt the technology [5].
Whilst much has been written about the acceptance and adoption of technology by
older adults, less has been written about their appropriation of technologies. Appro-
priation is a highly complex concept that is focused on the use of technology in a
meaningful context. This is much harder to investigate compared to technological
acceptance or adoption. As such, scholars, mostly guided by the postmodern traditions,
have attempted to come up with frameworks to assist with their understanding and
interpretation of technological appropriation by individuals in various sociological
contexts.
2.1 ICT and Older Adults

Although there is much research and development done on technological innovations
with the goal of assisting older adults and their specific needs, there is a lack of research
exploring the needs of older adults in appropriating technology in the context of everyday
tasks and life. This may be largely due to the following reasons: (a) older adults are
hard-to-reach as research participants, (b) the goal of many studies is usually focused on
the acceptance, adoption or use of technology, and older adults simply fall out of this
scope if they do not use, adopt or have a negative attitude towards technology.
Scholars have tried to address the research gap in different ways. Some focus on the
development of ICT innovations for older adults, and through such development argue
for an increasing demand and usefulness of innovations that can help maintain current
social ties or develop new ones [6, 7]. Communication devices such as mobile phones
help older adults to maintain their ties, and smartphones, with potential connectivity
and social networks available through games, apps, and social networking sites offer
opportunities to forge new connections and social ties.
According to the Pew Research Center’s Smartphone ownership report in 2013 [8],
in the U.S., 14.6 % of people over the age of 55 own a smartphone, while in Europe, it
is 18.9 % over the age 55. Research on the use of smartphones by older adults is largely
focused on smartphones as new healthcare and assistive solutions for elderly [3, 9].
Apps to monitor falls [10], monitor and control food intake [11], advocate medication
486 N. Pang et al.
adherence [12] or improving cognitive ability [13] are some of the common solutions
that have emerged on the smartphone.
Studies on older adults and smartphones can be broadly classified in two streams:
one that focuses on acceptance and use; the other is oriented towards the adoption of
technology. Studies belonging to the first tradition are interested in the effect and
impacts of specific functions or characteristics of smartphones (touch screen or inter-
face for instance), seeking to understand their usability, use and acceptance by older
adults [14–16]. A consistent finding from many of the usability studies conducted
suggest that older adults have difficulties using smartphones [16–19] and guidelines to
design better interfaces for older adults have been developed in response [20, 21].
The second tradition which is oriented towards adoption is focused largely on the
factors influencing adoption. For instance, Williams [22] did a study on how older
adults perceive iPhones using the Socioemotional Selectivity Theory (SST) and the
Technology Acceptance Model (TAM) by interviewing of 12 participants over the age
of 60, 2 of which do not own an iPhone. Perceived usefulness, communication,
information access, entertainment, and perceived ease of use were found to be moti-
vational factors for older adults to adopt and use iPhones.
Rahmati and colleagues [23] conducted a longitudinal quasi-experiment on 34
iPhone 3 users (aged 19 on average) over six months to demonstrate the influence of
Socioeconomic Status (SES) on how the iPhones were adopted. Their results show that
lower SES groups spent more money on apps and installed more apps as compared to
other SES groups; the lowest SES group did not find their iPhones as easy to use as
compared to other SES groups.
A problem of many acceptance studies is that technology is usually viewed or
assumed to be static and non-changing, whilst adoption studies tend not to acknowl-
edge structural properties of technology or social structures in users’ adoption of
technology. As a result, scholars such as Orlikowski [24] and DeSanctis and Poole [25]
developed the concept of appropriation to address the gap.
2.2 Smartphone Appropriation by Older Adults

Appropriation is a socio-cultural concept linking perspectives of technology acceptance
and use, and adoption. It argues for recursive relationships between social structures,
technology and human agency. Since the emergence of the concept, scholars such as
DeSanctis and Poole [25], Orlikowski [24] and Carroll [26] have offered models to help
guide research in understanding technology appropriation by various individuals and
communities.
Structurational models of technology typically argue that the use of technology by
human actors is done through their understanding of rules and norms: “…human agents
build into technology certain interpretive schemes (rules reflecting knowledge of the
work being automated), certain facilities (resources to accomplish that work), and
certain norms (rules that define the organizationally sanctioned way of executing that
work)” (p. 410) [27].
Building on the appropriation literature, Carroll [26] suggests that the evaluation
of technology by users results in four outcomes: appropriation, disappropriation
(abandonment), non-adoption, and simple adoption. It suggests that technology use

result in outcomes that lie on a continuum, with simple adoption or non-adoption on the
extreme end, and appropriation or disappropriation as outcomes that lie in between
these extremes.
This model (Fig. 1) argues that a technology may be adopted or non-adopted at
Level 1, and at Level 2, users start to explore and evaluate the technology even as they
adapt to it. During this time, they may disappropriate and abandon, or appropriate and
the technology becomes part of their everyday tasks and activities. All outcomes are
conditional: many factors can trigger re-evaluation of the technology and result in
changes in the outcomes.
Fig. 1. Model of technology appropriation (Source: Carroll 2004, p. 3)
In our ongoing study of smartphone use by older adults, we have found instances of
both non-adoption and disappropriation. Whilst confounding to our original research
aims to evaluate smartphone appropriation, these have contributed to new research
directions.
Research done on non-adoption and disappropriation is sparse with Selwyn being
one of the most prolific in writing about non-use of ICT by older adults [28–30]. As he
argued, little is known about the non-use phenomenon amongst older adults, especially
in terms of the reasons and the outcomes of non-use [29]. Many of the conventional
concepts of non-use are based on the technologically deterministic assumption that
using ICTs is inherently beneficial for all including the older adults. Furthermore, most
literature focused on use of ICTs rather than non-use and rendered non-use as a
problem to be solved [28]. These resulted in a gap: the technological deterministic
perspective has discounted the focus on the individual or the user who should be given,
to a certain degree, a role to play in making the decision whether or not to use a
technology. In other words, as Selwyn [28] advocated, it is important to understand
how individuals use technologies. It is our intention to address this gap by examining
the appropriation and disappropriation of smartphones by older adults.
488 N. Pang et al.
3 Method
Using in-depth interviews, the study aimed to explore the use and non-use of the ten
recipients of iPhones in a corporate social responsibility program by a telecommuni-
cations company in Singapore. The respondents received the phones in December 2012
and we conducted the first round of interviews in November 2013. The second round of
interview was done with four participants six months later in May 2014. The remaining
participants were either non-contactable or refused the second interview.
3.1 Data Collection

Silverline is a corporate social responsibility program by Singtel, a telecommunications
company based in Singapore, to promote the use of ICT by older adults. Second-hand
and refurbished iPhones were given away to selected older adults under the care of two
non-profit organizations serving older adults in Singapore. The first batch of phones
was given out to nine older adults in December 2013 with a free-of-charge one year
data plan. We approached the project manager of Silverline and expressed interest in
interviewing these nine recipients for the study. After IRB approval and agreement with
Silverline were granted, we contacted the recipients for their permission to visit their
homes or anywhere they wanted to meet for an interview. One of the nine interviewees
was sharing the phone with her sister whom she is living together with and so we were
able to interview ten older adults. The first round of interviews was conducted from 8th
to 19th November 2013.
The mean age of N = 10 is 76.2 years old, most of them are single and living alone
in a one-room apartment. Most live on their retirement pension and have fair health
conditions with some chronicle illnesses. Table 1 presents a summarized profile of
participants in our study.
A semi-structured in-depth interview approach was used, involving questions about
the respondents’ family background, health condition, employment (if any), and daily
activities. Open ended questions revealed contexts of their use and non-use of the given
iPhone, difficulties using the iPhone, reasons for non-use, their attitude towards older
adults’ using smartphones and the role that the iPhone plays in their lives, and their
attitudes towards ageing.
Table 1. Overview of participants

Gender Living Marital Source of livelihood Health
arrangement status conditiona
Men (6) Alone (6) Married (3) Salary (part-time) (1) Excellent (2)
Women With a roommate Single (7) Retirement pension (7) Good (2)
(4) (1) Family/Relative Fair (4)
With family (3) members (2) Poor (2)
a
Simplified labeling based on health condition of participants as declared on their own. Excellent
is without any illness or on-going medication. Good: with one illness or on medication with. Fair:
with 2 illnesses and on medication. Poor: with more than 2 illnesses and on medication. Very
poor: immobile.
A small audio recorder was used to record the interviews and transcribed each of
them immediately after each visit. Observation notes were included in the transcripts as
well and coded as memos in NVivo [31]. Photos were taken sporadically during the
interview as the researchers felt the need to capture certain aspects such as photos taken
in the iPhone. Some respondents could only speak Chinese so transcripts were trans-
lated into English. For the first phase of interviews in November 2013 with N = 10, a
total of almost 9 h of recordings, 446 pages of transcripts and 156 photos were col-
lected. For the second phase of interviews in May 2014 with N = 4, only observations
and notes of differences in the usage or non-use as compared to the first phase were
recorded.
3.2 Data Analysis

Using NVivo10, ten transcripts were coded in 3 stages: open coding, axial coding and
selective coding [32]. Open coding was used to code each line of each transcript;
responses associated with adoption, non-adoption, appropriation or non-appropriation
were marked and labeled with codes. Next, similar concepts were grouped into cate-
gories and axial coding was used to explore the relations between the categories. The
result of axial coding is a loose conceptual framework including casual conditions,
context, and consequences of each kind of use or non-use. In the last stage of coding
(selective coding), the categories were reexamined and synthesized into a series of
grounded concepts of appropriation and disappropriation.
A code book was developed to include code definition and their hierarchies. Using
the code book, 2 coders started coding separately and then the files were merged
together in NViVo. The inter-coder reliability was satisfactory (Cohen’s kappa = 0.75)
for most of the codes in all transcripts. A total of 1,544 responses were coded (open
codes) and categorized into categories.
4 Findings and Discussion
4.1 Appropriation
Unsurprisingly, positive perceptions of smartphones are associated with appropriation.
Participants also felt that being given the iPhone implied that they had to use it
otherwise it would be taken back. This provides many of them the motivation to
appropriate the smartphone into their everyday routines, or adapt to the smartphone,
introducing new routines into their lives. For instance, many participants use the device
to forage for information such as winning lottery numbers and send short messages.
But some participants have also shared how new activities are introduced into their
lives as a result of appropriation: “…it eliminates my boredom…my life will be boring
if I cannot play games [on his iPhone].” (Participant CS) (Fig. 2).
Another participant, Participant YH, talks about his discovery of new functions on
the iPhone: “…the phone [the iPhone] contains a lot of interesting things. This one
[pointing to his old mobile phone, a Nokia non-smartphone] doesn’t. It [the iPhone] is
fun…like the songs, I like the songs. This phone [is] like a friend”.
490 N. Pang et al.
Fig. 2. Some of the games played by participants (Source: Authors’ own)
Games and getting onto social networking sites are the most common elements of
the smartphone that appears to inject new routines and activities into their lives,
whereas other functions such as making phone calls, messaging, camera, surfing the
Web for information and music player are appropriated into the everyday lives of
participants.
Social support from others in the appropriation of smartphones is crucial, with
some participants relying on their neighbors for help. Participant CS described the
importance of such social support in encouraging his persistent use: “I will ask her [my
neighbor] if it [the iPhone] is spoilt or when I want to install new games I will [also]
ask her to help me”.
The result of smartphone appropriation is associated with feelings of empowerment
and status amongst participants in our study. Participant KL, for instance, shared about
her experience getting noticed holding the phone on a bus: “…people will ask me,
‘Aunty, you use this?’”. The smartphone is not simply a device, but something that is
appropriated as part of ageing and being respected as an older person in society.
Participant BM expressed his belief that the smartphone is a privilege accorded to him
as an older adult: “I think they respect this [pointing to his walking stick]…VIP
treatment you know…” and the iPhone is part of the package.
Such deep appropriation can be emotional, with one participant getting worked up
by the hypothetical scenario of living without the iPhone again: “I don’t think I will
give it back…if they take it back from me, I will ask them, “Why are you taking it away
from me?” I will keep asking them, and discuss with them. I won’t allow them to take it
back from me easily. No way. You gave it to me!” (Participant CC).
4.2 Disappropriation
Participants in our study reported substantial barriers to using the iPhones, resulting in
disappropriation. 85.2 % of the data tagged with non-use are associated with barriers to
using. These are further categorized into three main categories: (i) subjective barriers,
(ii) technological barriers, and (iii) situational barriers. Subjective barriers are associ-
ated with individuals’ attitudes and ability, such as the lack of knowledge on how to
use, or about the smartphone. Participant YH said: “I’m more familiar with others
[Nokia phone], and they are easy to use… This [iPhone]… I see wrongly… press
wrongly…” Participant CS also pointed out: “Most elderly… they only make and
receive calls, they don’t use the other functions.” In such cases, appropriation of the
smartphone is not full and meaningful.
Social support was as important in the lack of appropriation as it was important in
the appropriation of smartphones, as discussed earlier. All of the participants who
reported disappropriation were living alone and had infrequent interactions with their
neighbors, implying little external help from other smartphone users.
The lack of knowledge is compounded by declined mental and physical abilities
due to old age (accounting for 25.8 % of non-use). Participant AT encountered the most
difficulties with his iPhone because of his poor eyesight: “the keyboard is too small for
me to see. I can’t see. Although this is small [pointing to the Nokia] but I suppose I’m
used to it”. Participant BM expressed that even though he would like to use the camera
function, he could not use because of his shaky hands. Such disappropriation is con-
textual to the phase of ageing and condition of their wellbeing.
But disappropriation was not always related to physical or physiological barriers.
Some participants were reluctant to use functions that they were just not keen on taking
up. One example is the use of social networking sites such as Facebook, even for very
competent smartphone users. Participant NW said: “I know what it [Facebook] is, I
just don’t want to use it.” The fact that she uses certain elements of the smartphone but
chooses not to use other elements reflects how in this case, disappropriation is an
exercise of choice, a reflection of empowerment and strong internal locus of control
over the smartphone.
Technological reasons for disappropriation are associated largely with interface
issues. Participant GC relayed a story of how he once bought an Android smartphone
for a friend: “…and the next day she sold [the smart phone], saying [she] doesn’t know
how to use. Then I bought an old Nokia for her, and she said ‘this was easy, the other
[phone] I have to look at so many places to figure out how to call’”.
Cost is one of the greatest obstacles to persistent appropriation especially to this
group of interviewees because they are considered the below average class (live mainly
on retirement pension, one-room apartment on monthly rent). Participant KL, in talking
about gaming on the smartphone, explained to us the barrier to her fully appropriating
the smartphone: “…although I want to play [the games], I don’t dare to…I am afraid
that I need to pay if I keep on playing.” Participant NW echoed this sentiment: “…my
friends do not use the iPhone even if they have one, they say [it is] expensive”. This
fear of being charged is mainly because they do not have enough financial resources.
492 N. Pang et al.
The eventual disappropriation is also associated with fear. Participant BM, for
instance, always kept his iPhone in a pouch and then the pouch is further protected in a
plastic bag. He explained that he does not want to drop it, and so he had to be very
careful about using it.
5 Discussion
Our study showed that iPhones are used and appropriated/disappropriated in a variety
of ways. Some respondents appropriate them meaningfully, in the fullest sense of what
they are as smartphones, others do not. The concepts of appropriation and disappro-
priation are especially meaningful for the profile of older adults in our study. Appro-
priation and disappropriation emerged as concepts that can help to explain the ways
participants interacted with their iPhones. For instance, Participant CS was so into
playing games that he turned it into a gaming device to help him alleviate loneliness; he
did not use other communication functions of the phone. But iPhones were not
designed to only play games. Still, this was how Participant CS appropriated the iPhone
into his daily life.
Our findings echo Chen et al.’s [33] study on elderly’s use and non-use of ger-
ontechnology which includes various technologies like ATM, computers, mobile
phones, and smartphones. Respondents in Chen et al.’s study did not use certain
gerontechnology due to social support, lack of knowledge and ability, cost, and
interface which are similar reasons for how respondents in our study
appropriated/disappropriated the iPhones they had. That older adults are unable to use
smartphones due to ageing physical and mental ability also mediates the use of the
iPhones is consistent with other studies’ findings on ICTs’ usage by older adults [34,
35]. Knowledge on how to use is especially important as one of the respondents
repeated over and over again throughout the interview: “…I’m not familiar yet. I must
learn slowly. Must learn…Once I am familiar with it I can use it.” Other studies have
found that knowledge plays a key role in technology usage too [36, 37].
Many studies have found that positive attitude towards using technology is the most
influential factors to technological usage [33, 38, 39]. However, this factor did not
seem to influence the appropriation/disappropriation of iPhones very much in our
study, as participants with positive attitudes towards technology may not always
appropriate meaningfully. Besides, the fact that these studies looked at gerontechnol-
ogy [33] or technology in general [38] makes it difficult to grade the level of influence
of the factors to specific technologies.
We found other factors associated with meaningful appropriation/disappropriation:
fear of losing the iPhone, considering the iPhone as a social status, and using the
iPhone to pass time and decrease loneliness. Our findings also reinforced Selwyn’s
argument [30] that non-use is mediated by conscious decision. For example, one of the
participants knew about Facebook but does not use it at all because she insisted that she
did not need it. Such individual and conscious choice to not use certain functions of
smartphone reflects her human agency and her exercise of choice over the smartphone.
This notion applies to almost any technology, not only smartphone, as proven in
Selwyn’s earlier study on older adults’ use of computers [29]: some of them just do not
see a need in using computers and not tempted to use one either.
6 Conclusion
Our paper reports results on the appropriation and disappropriation of smartphones as

part of an ongoing study about smartphones and older adults. Our in-depth interviews
revealed insights on the factors behind both appropriation and disappropriation, and
how appropriation or disappropriation of the smartphone is integrated into everyday
routines and tasks. Some constraints exist, such as the limited number of participants.
However, given that older adults are hard-to-reach as research participants and it is
relatively hard to reach older adults who have had the opportunity to adopt a smart-
phone, our study provides rare insights on how older adults can appropriate or dis-
appropriate a smartphone when given access.
Acknowledgements. This research is supported by the National Research Foundation, Prime

Minister’s Office, Singapore under its International Research Centers in Singapore Funding
Initiative and administered by the Interactive Digital Media Program Office.
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Abilities to Use Technological Communication
Tools in Aging: Contribution of a Structured
Performance-Based Evaluation
Lisa Quillion-Dupré1(&), Emmanuel Monfort2, and Vincent Rialle1,3

1
AGIM, Université Grenoble Alpes, CNRS, 38000 Grenoble, France
{lisa.quilliondupre,vincent.rialle}@agim.eu
2
LIPPC2S, Université Grenoble Alpes, 38000 Grenoble, France
[email protected]
3
CHU de Grenoble, UF ATMISS - Pôle de Santé Publique/Dépt de Veille
Sanitaire, Grenoble, France
Abstract. New technologies remain little used by the elderly and their impact
is not sufficiently evaluated. Our research aims to evaluate the potential benefits
associated to the use of communication tools and specifically with digital
applications on touch pad. The present research compared the ability to use a
fixed or mobile phone and a touchpad, by 25 young adults and 25 older people,
living in the community and without neurological or psychiatric history.
Compared to younger adults, aging people produce more commission errors and
need more assistance to correct themselves, especially for the most recent
technologies. The data appear to validate a hierarchical assistance model to help
aging people using technological communication tools. They should be better
assisted in a strategic way, using reinsurance and specific cueing. The results
also indicate that the combination of a specific observation grid for standardized
daily living tasks is especially sensitive to evaluate autonomy loss in aging.
Keywords: Telephone Performance-based assessment Older person

Touchpad Errors Human assistance
1 Introduction
According to the World Health Organization (WHO) [1], the percentage of persons
aged 60 years and over is expected to double between 2000 and 2050. Besides, the
number of dependent people increases with age; Veber and Morel [2] reported 8 % of
dependent people among adults of 60-year-old and over against more than 60 %
beyond 95-year-old. At the same time, the number of cognitively impaired individuals
is brought to grow [1]. As a consequence, the lengthening of life expectancy constraints
society to face with a real challenge, specifically with the aim to support elderly
dependent people, or at risk of loss of autonomy, at home. The wide scope of ger-
ontechnology may provide innovative solutions both to promote assessments of daily
living and to overcome the disability in activities of daily living (ADLs) [3].

DOI: 10.1007/978-3-319-20892-3_48
Abilities to Use Technological Communication Tools in Aging 497
Even if it’s a common technology, the telephone is a communication tool essential

to maintain independence and autonomy in aging people living in the community.
Indeed, it enables to keep in contact with people living far away as well as to organize
home-help services or call for help if needed, contributing to ensure personal safety [4],
and keeping some control over his/her own life [5]. Furthermore, the ability to use the
phone is identified as sensitive to early cognitive decline associated with dementia
disorders [6]. More generally, the adaptation to new communication technologies
becomes unavoidable to remain actively involved in our society. In addition, learning
and using computers may develop the sense of well being, may stimulate the world
understanding, and increase the sense of belonging of aging people [7]. Among these
technologies, tablets offer both the opportunities of phone and computer, and then may
be quite interesting. Indeed, for the elderly, the touch-sensitive screen seems to present
the advantage of simplicity of use, compared with the computer [8, 9]. However, new
technologies remain little used by the elderly, and their impact is not sufficiently
evaluated, even in healthy individuals.
When developing easy-to-use technologies, adapted support to assist aging user in
handling of the technology is an apparent need to encourage its adoption [10] and
particularly to increase perceived sense of control, which strongly determines tech-
nology adoption [11]. Moreover, high quality training with a focus on establishing or
restoring a person’s confidence in technology but also in his/her own capacities would
facilitate learning [12]. Thus, it is essential to promote education and learning, with
seniors, their family, and professional caregivers. However, an adapted and effective
support could not exist without a fine evaluation of the difficulties’ nature and of the
cues provided during the task.
A wide variety of tools can be used to assess ADLs: self- and proxy-reported,
performance-based measures, as well as direct observation at home. Paper-and-pencil
questionnaires allow easy and quick use but have been criticized for their lack of
ecological validity: Items often rate a global functioning in an activity and can
sometimes only be assumed to respond on a all-or-nothing basis, the measure do not
then reflect the nature of the difficulty, the gradual nature of the disorder, or its het-
erogeneity [13]. Moreover, the activities are generally little or globally described,
allowing the interpretation of respondent comprehension and appealing also to his/her
memory or retrospection. Results obtained with self-reported measures may also suffer
from bias, like over or underestimation of the abilities [14, 15]. In order to propose
individually adapted readaptation activities, we need a more detailed ADLs measure,
analyzing the task step by step and enabling to give the adapted cue at the right time.
Direct observation tools enable to collect information on subject’s performance by
evaluating effective capacity, using real-world situations. They are considered to be less
influenced by the education and cultural level, and could be more valid and objective
measures than self-reports [15]. However, they have certain disadvantages: a major one
is the time required, one hour and a half on average, for the observation [16]. In
addition, data collection may require a suitable room with a more or less substantial
specific material, a greater training of the observer, or video recording, making these
assessment instruments barely usable in clinical practice [15]. Nonetheless, they pro-
vide accurate and relevant information on the patient’s functioning, particularly useful
in case where there is no family support.
498 L. Quillion-Dupré et al.
Many researchers using performance-based measures have taken an interest on the

type of errors occurring during the task execution. To allow for subtle ADLs analysis,
Schwartz et al. [17–19] proposed two main errors categories: omission and commission
(including objects substitution, action-addition, sequence errors like anticipation-
omission, performance of a step in reverse order or perseveration). Several studies
included this error taxonomy [20, 21]. Anselme et al. [22] did too and added initiation
errors: when the participant does not start spontaneously the activity, for any reason.
According to Giovannetti et al. [21], action-additions while linked to commissions or
omissions will be conceptually different and have to be distinguished. Healthy people
are likely to produce errors, although less than people with a neurocognitive disorder,
and mostly of commission type [23], nonetheless omissions should be likely to be
produced by healthy young participants in less familiar tasks [24]. Furthermore,
Bettcher et al. [25] highlighted the significance of self-correcting ability as a relevant
indicator of living alone at home. Indeed, the number of errors being never zero, detect
and correct them is therefore of special importance. Different levels of hierarchical
assistance can be provided to help people who do not correct themselves. Neistadt [26]
proposed to make a distinction between general verbal (providing guidance with a
series of questions) and physical assistance. This distinction has been reproduced in the
analysis grid from the Profinteg tool [22, 27]. The authors added specific (“Would this
not be written somewhere?”) and total verbal assistances (“You have to…”). This
enables to determine which assistance is adapted to the subject’s difficulties, while
exploiting his/her potential.
In that context, our research aims to precise the actual capacity of healthy aging
persons to use fixed and mobile phones, and mobile tablet computers compared to
young adults. We analyzed their performances in three usual tasks, considering the
errors generated as well as the requested and provided cues.
2 Method
2.1 Participants
The study population consisted of two healthy groups, constituted by people living in
the community and with no known cognitive impairment. For inclusion in the study,
participants had to be between 18 and 40 old for the “younger” group and 64 or older
for the “older” group, as well as having French as mother language. Visual and/or
hearing impairments were exclusion criterion except if they could be compensated with
technical aid(s). Other exclusion criteria were: reported history of psychiatric disorders
or stroke, refusal to be filmed, or scoring less than 26 at the Mini Mental State
Examination (MMSE) [28, 29]. We also considered the symptoms of depression with
the 20-items French version of the Center for Epidemiological Studies Depression
Scale (CES-D) [30], due to the possible impact of depressive symptoms on attention.
Education status may reflect cohort effects. So, we administered a vocabulary ques-
tionnaire (Mill-Hill part B, French version) [31] as an indicator of the socio-educational
level.
Fifty participants were met, 25 in each group. Three were excluded from the
“older” group due to exclusion criteria: one because of a disabling visual condition and
the two others because their MMSE score was 23 and 25.
Demographics of the samples are presented in Table 1. The cognitive level was
significantly different (t(31.797) = 3.34, p < .01), which is not surprising if we consider
that the aging process results in a slight decline of these performances. As expected, the
“older” group had a statistically significant high vocabulary level (t(44.94) = −4.21,
p < .001). No significant differences were found between groups in relation to years of
education and level of depressive symptoms.
Table 1. Characteristics of the participants

Age Education MMSE CES-D Mill-Hill B
(years)
M Range M Range M Range M Range M Range
SD SD SD SD SD
“Younger” n = 25 31.8 18–40.4 14.5 9–20 29.2 28–30 11.1 5–25 35.6 28–41
6.8 3 0.8 5.6 3.0
“Older” n = 22 73.5 64.2–88.7 13.7 7–20 28.0 26–30 15.3 0–28 39.0 33–43
6.6 3.4 1.4 8.8 2.6
2.2 Procedure
A questionnaire was administered to collect demographic and technology habits
information, including frequency of use. We also assessed global cognitive functions
(MMSE), vocabulary level (Mill Hill part B) and depressive symptoms (CES-D).
Finally, in order to meet the objectives of the research, we evaluated and compared the
capacity of use in fixed phone, mobile, and tablet. The evaluation was individual and
without time limitation. The analysis of the answers was based on verbal and
non-verbal elements, and subjects were videotaped while they were using the three
communication tools. Videos will next be analyzed by means of a specific scorecard.
The local ethic committee approved the research, and all participants signed the
review board-approved consent form providing permission to videotape
2.3 Materials
To assess the capacity of use in the three communication tools, we adapted the hier-
archical tasks of the telephone use domain from the Observed Tasks of Daily Living-R
(OTDL-R) [32], a performance-based assessment tool of IADL. Participants had to
perform three tasks of increasing difficulty and involving their ability to use the three
technologies in a usual everyday activity: search for a phone number in a document
before dialing it. For the third task, they also had to look for the date of a scheduled
appointment in a medical letter then to check it in a diary. The evaluation tasks differed
by the structuring level of material mentioning the phone number to dial and by the
level of executive constraints linked to the organization and to the control of the steps
required to complete the task. We focused on difficulties in using and understanding.

We always assessed the technologies in the same order: from the simplest or more
common (i.e. fixed) towards the more complex or less common (i.e. tablet). To analyze
participants’ performances, we used an adapted scorecard developed on the basis of the
Profinteg grid [22]. To construct the analysis grid, we sequenced each task, establishing
the nature, the number and the chronological order of the necessary steps required to
carry out the activity, thus defining a reference script. We were also interested in the
types of errors likely to be made (Table 2) and hierarchically listed the cues that might
be provided during the task (Table 3). The order was pre-determined, based on a
graduated set of responses: from the less informative to the most informative one. The
participants were given no indication until they were stuck, asked for help, or made a
mistake. According to Bettcher et al. [25], we decided to account the number of
self-corrections as well as of external control strategies.
Table 2. Errors typology

Error type Description
Initiation The participant does not spontaneously start the activity after 15 s (for any
reason) or says, “I don’t know”.
Omission The participant does not execute a step (including forgetting of the contents)
(e.g. He/she doesn’t read the number). To be considered as an omission, an
error must not be a consequence from any other error type.
Erroneous Realization in an incorrect, inappropriate way, or not at the right time (e.g.
execution He/she make a mistake in dialing the number or doesn’t read the right
number), including perseverations: A step is executed more than once (e.g.
Read the number, look at the instructions and then read again the number)
Action-addition Performing an action that cannot be considered like a necessary step to
complete the task (e.g. write the appointment in the diary)
Table 3. Typology of the provided cues

Cue Description
type
General Encouraging to continue or advising the participant of an error but without specified
which one and where (e.g. “Be careful!”- “Hm hm”)
Specific Verbal indication on the nature of the error but without providing information about
what needs to be done or how to do it (e.g. “You are forgetting something.”)
Total Detailed explanation of what the participant has to do (e.g. “Press the star * key”)
Gestural Showing the right key or number
Physical Performing the step for the participant (e.g. Press the star key)
2.4 Statistical Analyses

To identify a difference in the use of communication technologies and age effect, we
used a multivariate analysis of variance with repeated measures (MANOVA), under the
assumption that there is a gradual progress of the technologies’ complexity. First, we
analyzed errors and assistance means. Then, we considered the performances more in
details and compared the distributions of each type of errors and cues.
3 Results
3.1 General Results

We explored the capacities to use three communication technologies (fixed and mobile
phones, and tablet computer) by “younger” and “older” people, considering the number
of errors, cues, self-corrections, and control strategies. Repeated-measure MANOVA
analyses confirmed that there were significant multivariate effects for age group
(λ = .320, F(4,41) = 21.8, p < .001), technology (λ = .225, F(8,37) = 15.9, p < .001),
and for the interaction between age and technology (λ = .270, F(8,37) = 12.5, p < .001).
Univariate between-group analyses revealed that the “older” group significantly pro-
duced greater total error (F(1,44) = 64.93, p < .001), needed more cues (F
(1,44) = 50.66, p < .001), and used more control strategies (F(1,44) = 21.78, p < .001).
Within-group univariate analyses indicated significant differences between technolo-
gies for the sum of errors (F(1,1.65) = 58.87, p < .001) and cues (F(1,1.68) = 35.01,
p < .001).
There were significant linear and quadratic effects of the technologies’ complexity
for the total number of self-corrections (respectively, F(1,44) = 24.00, p < .001; F
(1,44) = 11.81, p < .001), errors (F(1,44) = 85.07, p < .001; F(1,44) = 12.47, p < .001),
and cues (F(1,44) = 51.55, p < .001; F(1,44) = 4.00, p = .05). There was also a linear
effect of the interaction with the age factor for errors (F(1,44) = 50.73, p < .001) and
cues (F(1,44) = 62.97, p < .001): that is a significant major effect for aging people
(Fig. 1).
Further analyses showed that, when using the tablet, “younger” produced signifi-
cantly more errors (fixed: t(24) = −2.63, p = .015; mobile: t(24) = −3.24, p < .01) and
self-corrections (fixed: t(24) = −2.91, p = .008; mobile: t(24) = −2.70, p = .012). They
also needed more assistance with the fixed phone than with the mobile (t(24) = 3.26,
p < .01). Other differences (Table 4) were not significant.
“older” needed significantly more cues with the tablet [mobile: (t(20) = −4.72,
p < .001); fixed: (t(20) = −7.19, p < .001)], and with the mobile than with the fixed
phone (t(20) = −4.28, p < .001). Similarly, they produced more errors with the tablet
(mobile: t(20) = −600, p < .001; fixed: (t(20) = −8.31, p < .001) and with the mobile
compared to the fixed phone (t(20) = −4.11, p < .001). The number of self-corrections
was also significantly more important with the tablet (fixed: t(20) = −3.77, p < .001;
mobile: t(20) = −3.65, p < .01). Other differences (Table 4) were not significant.
Fig. 1. Line graph – means of errors across technologies by age group
Table 4. Errors, cues, self-corrections, and control strategies scores by technology type and age
group.
“Young” “Old”
mean (SD) mean (SD)
Total number of errors
Fixed phone 1.4 (1.6) 2.4 (2.0)
Mobile phone 1.2 (1.0) 5.1 (3.7)
Tablet computer 2.5 (1.9) 11.1 (4.4)
Total number of cues
Fixed phone 4.4 (3.1) 8.9 (5.6)
Mobile Phone 2.3 (2.0) 18.7 (13.4)
Tablet computer 3.2 (2.9) 33.8 (20.2)
Total number of self-corrections
Fixed phone .2 (.5) .2 (.4)
Mobile phone .2 (.4) .2 (.4)
Tablet computer .7 (1.0) 1.3 (1.3)
Total number of control strategies
Fixed phone 2.0 (1.4) 3.8 (2.7)
Mobile phone 1.8 (1.5) 4.5 (2.7)
Tablet computer 1.6 (1.6) 4.3 (2.5)
3.2 Errors and Cues Patterns

We explored in more details the errors produced (initiations, omissions, erroneous
executions and action additions) and the assistance provided (general verbal, specific,
total verbal, gestural and physical) across the three technologies for “younger” and
“older”. Repeated-measure MANOVA analyses highlighted significant multivariate

effects for age group (λ = .35, F(4,41) = 19.33, p < .001), technology (λ = .27, F
(8,37) = 12.66, p < .001), and for the interaction between age and technology (λ = .37,
F(8,37) = 7.94, p < .001) for errors, as well as for assistance (respectively: λ = .40, F
(5,40) = 12.17, p < .001; λ = .35, F(10,35) = 6.43, p < .001; λ = .314, F(10,35) = 7.66,
p < .001). Univariate between-group analyses showed that “older” produced overall
significantly more omissions (F(1,44) = 30.01, p < .001), erroneous executions
(F(1,44) = 64.34, p < .001), and initiations (F(1,44 = 7.10, p = .011) than the “younger”
group. They also needed more general (F(1,44) = 47.18, p < .001), specific
(F(1,44) = 61.42, p < .001), total verbal (F(1,44) = 25.94, p < .001), and gestural
assistance (F(1,44) = 5.63, p < .001).
Within-group univariate analyses indicated significant differences between tech-
nologies for the number of executions (F(2,88) = 69.91, p < .001) and action additions
(F(2,88) = 6.38, p < .01) produced, as well as for general (F(2,88) = 30.44, p < .001),
specific (F(2,88) = 32.99, p < .001), total verbal (F(2,88) = 13.92, p < .001), and
gestural assistances (F(2,88) = 3.55, p = .042). Further analyses showed that the
“younger” group produced only initiation errors with the fixed phone (m = 0.16,
SD = 0.37, t(24) = 2.138, p = .043), and significantly more erroneous execution errors
with the tablet (m = 1.84, SD = 1.40) than with the fixed (m = 0.76, SD = 1.23,
t(24) = −3.36, p < .01) and mobile (m = 0.56, SD = 0.65, t(24) = −4.67, p < .001)
phones. The “older” group produced significantly more omission (m = 2.05, SD = 1.02,
t(20) = −3.02, p < .001), erroneous execution (m = 8.05, SD = 3.40, t(20) = −8.92,
p < .001) and initiation errors (m = 0.71, SD = 1.19, t(20) = −2.55, p = .019) with the
tablet than with the fixed phone (respectively, m = 1.14, SD = 1.08; m = 1.09,
SD = 1.27; m = 0.14, SD = 0.35). The difference between erroneous execution errors
scores was also significant between mobile phone (m = 3.10, SD = 2.45) and tablet
(t(20) = −6.38, p < .001) as well as fixed phone (t(20) = −4.22, p < .001). Other
differences were not significant. Figure 2 represents significant differences between
groups.
“Older” group’s scores of general and specific verbal assistance were significantly
different between all the technologies (p < .001). Total verbal assistance also increased
significantly with the technology [fixed phone (m = 0.14, SD = 0.35) compared to
mobile phone (m = 0.67, SD = 1.20, t(20) = −2.25, p = .036) compared to tablet
(m = 1.86, SD = 1.82, t(20) = −2.61, p = .017)]. By contrast, the “younger” group
needed only more general verbal assistance with the fixed phone (m = 3.8, SD = 2.5)
compared with the mobile (m = 1.76, SD = 1.33, t(24) = 3.89, p = .001). Finally, needs
were also different between groups (Fig. 3).
4 Discussion
We compared the ability to use a phone (fixed and mobile) and a tablet computer
considered across the total number of errors, cues, self-corrections and control strate-
gies, by young and aging people, living in the community and without neuropsycho-
logical or psychiatric history. Every kind of errors occurs, even in young participants.
Nevertheless, older participants produced more errors than younger adults and needed
9
8 ***
7
6
Means
5
4
***
3
*** "Younger"
2 *
* "Older"
1 *
*
0
Action-Add
Action-Add
Action-Add
Execution
Execution
Execution
Omission
Initiation
Omission
Initiation
Omission
Initiation
Fixed phone Mobile phone Tablet
Fig. 2. Differences between the two groups in the distribution of error types for the three
technologies (*p < .05; **p < .01; ***p < .001).
Fig. 3. Differences between the two groups in the distribution of assistance types for the three
technologies (*p < .05; **p < .01; ***p < .001).
more assistance. In particular, the results highlighted that aging people produced more
omission, execution and initiation errors than young adults. Errors are mostly erroneous
execution ones, like reported in previous research in healthy aging population [22].
Nonetheless, we only considered the sum of errors, not the proportion of each error
type which might be helpful to confirm patterns suggested by Fig. 2 and to verify if
omission errors are more frequent in healthy adults when executing less familiar tasks
[24]. Unexpectedly, we did not observe any differences concerning omissions for
younger participants. According to our results, the distinction between omissions,
commissions, initiations and action-additions, mainly used with impaired people,
seems to be sensitive in healthy aging people. Nevertheless, we did not consider the
commission error category in details. Yet, it includes several types of errors [17–19],
like errors of quality. More explorations are needed considering the number of errors of
quality identified, while they were relatively rare in previous research [20]. It may be
related to the tablet handling, in particular the use of the touch screen may cause quality
errors. It would then be insightful to explore if the nature and the number of errors
produced are linked to the specific constraints of the situation (assessment context,
documents to read, or technology to use).
Our findings confirm the increasing complexity of the three technologies. Never-
theless, the technology seemed to mainly impact aging people performances: They
needed more assistance with the mobile phone than with the fixed phone, and with the
tablet computer than with the two others. They also produced more errors with the
tablet than with the cellphone, and with the cellphone than with the fixed phone. By
comparison, younger participants only produced more errors when using the tablet
computer. Moreover, there was a significant difference in the number and the type of
human assistance provided: Aging people needed more help, and from higher level, to
correct themselves and to learn to execute the task, especially for the most recent
technologies. Despite this, all participants succeeded to use the three technologies, even
when they had never had before the opportunity to use a computer tablet, confirming its
potential simplicity of use [8, 9]. Nonetheless, the link between number of errors and
cues with the experience of use deserves further study. Indeed, if 44 % of the younger
participants had a tablet at home, they were only 13.6 % among the elderly. And even if
the latter were 90.9 % to have a mobile phone, many of them pointed out that the model
of the experiment was different from their own. Then, aging people could have more
difficulties to adapt to a new technology, and not knowing the technology may increase
the difficulty to anticipate the next step to execute. The helpfulness of the hierarchical
assistance model seems also to be confirmed. However, more research are needed to
confirm if it is more useful to start with general verbal cues in usual situations
(increasing cues), while with unusual technologies or for new learning, it may be better
to first propose a higher level of help (decreasing cues).
We did not notice any difference between groups for self-corrections; nonetheless,
it is quite interesting that aging respondents produced more errors while using more
control strategies. Furthermore, they seemed less confident, asking more frequently for
help or seeking confirmation. The findings suggest that the main difficulty in the use of
communication technologies concerns the decline of efficiency of control strategies and
also support the recommendations of Berner [12] concerning the necessity to restore
the confidence of the person. Aging people should thus be better assisted in a strategic
way, using reinsurance and specific cueing while using the technology.
We acknowledge several limitations to this study. First the sample size was quite
small therefore generalizations of the findings are limited. Secondly, we did not explore
the inter-rater reliability to verify the objectivity of our analysis grid. Some others
variables need also to be explored like, for example, the link with neurocognitive
measures or with the frequency of use of each technology. Thus, more research is
needed to confirm our results and to advance in the understanding of the data compiled.
Nevertheless, favoring access to new information and communication technologies for
the elderly give them the opportunity to be more involved in society and contribute to
healthy aging. Training has a major role to limit the risk of foreclosure. Finally, the
difficulties observed in aging people living at home alone indicate that the combination
of a specific observation grid to analyze standardized daily living tasks may be espe-
cially sensitive to early neurocognitive disorders.
Acknowledgements. Funding for this project was provided by a grant from Région
Rhône-Alpes.
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Elderly and Tablets: Considerations
and Suggestions About the Design
of Proper Applications
Eliseo Sciarretta1, Andrea Ingrosso1, Valentina Volpi1,2,

Antonio Opromolla1,2, and Roberta Grimaldi1,2(&)
1
Link Campus University, Via Nomentana 335, 00162 Rome, Italy
{e.sciarretta,a.ingrosso,v.volpi,a.opromolla}
@unilink.it, [email protected]
2
ISIA Roma Design, Piazza della Maddalena 53, 00196 Rome, Italy
Abstract. In this paper, the authors support the idea that tablet is the ideal tool
to assist and enhance the elderly living by providing them with value-added
services. Currently the risk is that a poor design interface may exclude this
substantial part of the population from using useful technologies because of their
specific age category requirements. So, after an analysis of the related academic
literature and an assessment both of elderly needs and tablet limits and potential,
the authors select a set of considerations and suggestions for the design of tablet
applications for elderly, in order to facilitate the interaction.
Keywords: Elderly Tablet Interaction design Design considerations and

suggestions
1 Introduction
Nowadays, the adoption and the usage of technologies are increased. Specifically, due
to the size decreasing and computational power increasing of devices, technologies
permeate people lives and enhance their abilities regardless of their level of technology
confidence. At the same time, the economical affordability of the large part of devices
has enlarged the ICT customers base. As a consequence, a large set of services is made
available through these devices. However, a large share of the population is still on the
fringes of this trend: the elderly. Several surveys, including one conducted by the
United Nations [1], show that the world’s population tends to aging. In addition, a
study of the European Union [2], back in 2012, states that in 2030 30 % of the
European population, a percentage that corresponds to more than 150 million people,
will be over 65 years old.
Technologies can really assist and enhance the old people living by providing them
with value-added services, but a poor design interface may impede it. Indeed, ignoring
the requirements for this specific category of users usually regarded as fragile and in
need of support may intensify the risk of excluding a substantial part of the population.

DOI: 10.1007/978-3-319-20892-3_49
510 E. Sciarretta et al.
So, the challenge is to make this part of population able to fully and consciously use
technologies for their own needs by designing apps and devices with the goal of
creating systems that facilitate the interaction.
First of all, designing an interactive service for the elderly involves a choice on the
device on which the service is delivered. The authors agree with the idea shared by the
academic literature that tablet can be a particularly suitable device for get elderly close
to the “digital services” and provide them with applications tailored on their age
category requirements. This consideration further arises from a reflection about the
comparison between two studies. In detail, altough the Audiweb statistics report that
25 % of 40 millions of Italian Internet users (age range: 11–74 years old) access
through tablet, a study conducted by the authors of this paper on elderly healthcare
shows more positive results. In effect, on a sample of 192 respondents with an average
age of 71 years, 32 % access to the Internet through tablet. In consideration of this, it
can be affirmed that elderly have a predisposition towards the use of the tablet.
Obviously, although tablet is not the panacea, the problems generally occurring in
the interaction between the elderly and other type of devices decrease by using tablet.
However, a proper design in user interfaces is needed, in order to assure high service
usage. So, in this paper the authors aim to select a set of considerations and suggestions
to design tablet applications for elderly.
In detail, in the following section, the authors investigate the proper design features
for elderly-oriented tablet applications that emerged by the analysis of the related
academic literature, while Sect. 3 focuses on elderly needs and tablet main strengths.
Thus, in Sect. 4, the authors identify a selection of design considerations and sug-
gestions in order to create applications actually usable by the elderly.
2 Overview on Elderly-Oriented Design in the Academic

Literature
The evident difficulties of elderly in using general digital interfaces led user interface
designers to find more inclusive solutions. One of the first challenges in the interface
design for elderly is to engage old users who infrequently use technologies. Old people
view themselves as being “too old” to use certain technologies. In detail, they believe
technology offers no benefits or it is too difficult to learn, avoiding it as a consequence
[3]. This attitude by the elderly population depends on the level of technology
understanding that can directly and proportionally affect the level of confidence in the
face of technology [4, 5]. In addition, old people may be reluctant to adopt technologies
that do not meet their needs [6]. So, in order to promote the use of the device as a
support rather than as a constraint, it is fundamental for designers to understand the
common difficulties that elderly face when using new computing devices (e.g.: tablets),
following a proper design method from the very beginning of the design process.
The academic literature has largely investigated the elderly user problems and
needs in order to identify the most suitable kind of support that technology may offer.
Williams et al. [4] identify several categories of impairments (cognition, auditory,
haptic, visual, and motor-based troubles) that ideal and complete human-computer
interface solutions for the elderly should take into account. Several studies focus on
Elderly and Tablets: Considerations and Suggestions 511
touch screen as the best interaction method for the elderly, considering pen or fingers
interaction, one or two hands, single or multi-touch gestures. Still, according to
Williams et al. [4], touch screen proves to be a more useful interaction method than
keyboard and mouse in computer interaction (e.g.: because of possible problems caused
by arthritis and swollen fingers). Favilla et al. [7] identify touch screen technologies as
suited to be used by users affected by memory, cognitive, behavior and emotion
diseases, since they are more portable technologies and easier to use than a computer.
In addition, touch screen technologies have been continuously improved in touch
resolution, multitouch interaction, luminance and high resolution screens, resistive and
capacitive technologies, and gestures recognition, more and more meeting elderly
requirements [8].
Some authors take into account the use of the tablet to overcome elderly impair-
ments and support them in their activities. In detail, the use of a capacitive touch screen
tablet is recommended as it causes less apprehension by avoiding the interaction with
intermediary devices, such as pen [8]. So, the capacitive touch screen tablet can be
considered a direct input device to interact with, since it only needs a direct contact on
the display screen. According to Vasconcelos et al. [6], the tablet is better suited for
novice users or those that do not want to memorize commands, as it demands less
training and it is easier to use, since it requires little hand-eye coordination and minimal
spatial (cognitive) demands. So, it is a suitable device for older people.
In other studies, some of the tablet features are considered in comparison with
similar devices, such as smartphone. As the latter, the tablet is a mobile device. This
allows old people to use it in a comfortable place and position, especially meeting the
needs of users with physical impairments or who are bedridden [6]. But older users
encounter great difficulties in using smartphone [9], e.g. because of the small size of
buttons and display [5], while the tablet offers a larger display than a smartphone and
the possibility to have labeled icons and larger fonts. However, the previous use of a
smartphone make easier for the elder the use of the tablet, since she/he is already
confident with settings that are similar [4].
The tablet could present even constraints. For example, Favilla et al. [7] report the
difficulty encountered by elderly in making capacitive contact with the touch screen
surfaces. Moreover, capacitive touch screen tablet does not offer any haptic response
for users [4], while a traditional resistive panel is based on a logic of interaction closer
to the interaction modes used in the physical world (e.g.: to push a switch button, or to
lean a finger against a surface). Therefore, old people could be more used to exert
pressure, rather than to swipe the fingertip, and even the difference can be hard to be
understood by older adults, especially those affected from dementia [10]. Due also to
elderly poor physical coordination [5] and slowed ability to combine motor and cog-
nitive skills, multi-touch interaction, typical of capacitive touch screen, is not recom-
mended for the elderly people (e.g.: rotate and zoom actions get diffculties for them)
[11]. At the same time, resistive touch screen requires to exert and sustain a certain
pressure that could represent a problem for older users [8]. Device inclination is another
important element to consider, because of the glare on glossy screens. Since their
dimension and weight, tablets are poor handling, so they may require the support of a
table or a stand [10]. Regarding audio feedback, the sounds from the application or the
device could be another hindrance for old people, startling or confusing them, or being
unheard due to hearing loss [10], even if usually it is possible to adjust the levels of the
sounds produced. Finally, one of the major risks with touch screen device is to acci-
dentally give an input to the system in use. The risk may be higher for older people.
Otherwise, for a great part of the problems reported, a proper design methodology
can offer an easy way out and create consistency. In this regard, tablet offers the
possibility to give elderly applications with rich design interfaces. It is a very important
feature, since a poor interface design may prevent elderly from using it. Several works
proposed suggestions for designing mobile devices for older people, focusing on
motivational and usability issues [6, 9, 12]. In addition, a participatory design involving
the users in the ideation process represents an essential approach to create more useful
and relevant services [13, 14].
In evaluating the suitability of the tablet for elderly, not only the technology, but
also the social context they are used to has to be considered. Although mobile devices
are generally designed for personal use, they can be usefully used in group activities,
too (e.g. in collaborative music and game activities), to successfully engage the target
audience [15].
In concluding, elderly could benefit from tablet (and technology in general) in order
to be supported in a great number of application fields and everyday activities,
achieving a more independent living [5, 15–17].
3 Framework
In this section, the authors intend to define the main characteristics about the subjects of
this study: elders and tablets. The emerged elements will be useful in order to define the
considerations and the suggestions for designing proper tablet applications for elderly
in Sect. 4.
3.1 Users
United Nations define “older persons” as “people aged 60 years or over” [1] and predict
that by 2050, the share of older people as portion of world population will reach
21,1 %. Among them, the share of persons aged 80 years old or over will reach 19 %.
In this section the authors focus on the peculiarities and habits of this age group,
considering its prevalent impairments, since they can affect the user interfaces of tablet
applications.
Older people are a highly heterogeneous group regarding interests, preferences,
skills, experiences and abilities, but they have in common the emergence of impair-
ments affecting both physical and mental activities [4, 6, 7, 18].
The main impairments in physical activities concern movements (e.g.: difficulties in
moving and controlling arms, hands, and legs; low coordination and flexibility; diffi-
culties in maintaining movements; loss of tactile sensitivity; motor tremors), vision
(e.g.: partial or poor vision; amplitude reduction of visual field; difficulties in visual
perception of colours, contrasts, brightness, dark adaptations, etc.), and hearing (e.g.:
reduced hearing, firstly of hear high-frequency sounds).
The main cognitive difficulties concern memory (i.e. working, spatial, and
long-term memory), attention (e.g.: decrease of the selective attention and difficulties in
managing information, causing confusion and disorientation), response time (to the
stimuli), executive functions (e.g.: planning and executing tasks aimed at a purpose;
problem solving; decision making), motivation (i.e. the older people need to be strongly
motivated to do something), and learning processes (e.g.: difficulties in learning new
information and in adapting himself/herself to new situations).
Physical and cognitive conditions not only affect the daily activities (e.g.: in
mobility, shopping, personal care, etc.), but also the emotional state of older people,
creating the needs of being encouraged and comforted, in order to do not let them give
up their self-sufficiency.
Even the relational aspects of their lives are certainly compromised from being
retired and having lost a more active social role. For these reasons, they need to build or
strengthen their social networks, also as relief for loneliness and boredom.
However, elderly are usually considered wise, because of their gained experience
and knowledge allowing them the identification of patterns and models: wisdom is here
seen as the ability to improve problem solving and finding solutions.
The elements above discussed could be seen under different points of view: as
needs (e.g.: social, security, and care need), as elements to be trained and improved
(e.g.: the cognitive abilities can be kept constant with exercise, allowing continuous
learning), and as elements to be considered in designing architecture, communication,
and content aspects of interactive systems (e.g.: difficulties in color perception affect
the use of colours in a mobile application user interface).
Older people are considered as “digital immigrant” [19], having a generalized
difficulty in using new technologies and interactive systems. Indeed, in respect of
“digital native”, older people need to understand how an artefact works, before using it.
3.2 Tablets
Due to its own intrinsic features, the tablet is considered by the authors of this paper as
the device better suited to enable the inclusion in the digital world of those categories of
users who have little or no familiarity with technologies, such as the elderly.
In this section, the authors try to give evidence of what these features are, focusing
on characteristics, potentialities, and limits of the technological devices usually known
as “tablets”.
First of all, a clarification on the terminology is needed. A tablet PC is commonly a
laptop that allows a direct interface with its screen through fingers (or a pen). In other
words, it is a Personal Computer with additional input modes than mouse and
keyboard.
This definition lead to a form-based classification, which consists of at least three
categories:
1. Slates are devoid of a physical keyboard, so for data entry a software keyboard or
other forms of insertion (such as speech recognition) are required. Since 2010, when
the Apple iPad was first marketed, the term “tablet” is commonly associated with
these devices, although improperly. Within this category, another distinction con-
cerns the screen size: mini tablets are devices with a smaller screen (usually about 7
inches), while standard slates screen size is 9–10 inches. Mini tablets are the result
of a hybridization process with smartphones. The same process has led more
recently to the creation of the so-called Phablets (phone plus tablets), i.e. (mini)
tablets that integrate telephone features.
2. Convertibles are real laptops with one main difference: thanks to a special swivel
joint, their screen can be rotated and folded over the keyboard, so that it disappears.
The keyboard, usually “hidden”, can be extracted at any time, in order to make the
data entry easier or to enable the interaction with applications not designed for
touch screens. Due to its flexibility of use, convertible was the most popular type of
tablet, until the advent of the iPad and similar devices.
3. Hybrids have a keyboard that can be attached or detached depending on the needs.
This category had not a wide diffusion, since slates often have keyboards that can be
connected via USB or Bluetooth.
The main differences among the categories of tablet are summarized in the Table 1.
Acknowledged this differentiation, hereafter with the word “tablets” the authors
refer to the slate tablets.
The exclusive use at most of fingers or of a pen characterizes the tablet users’
interfacing mode.
Unlike convertibles, tablets need to run an operating system specifically designed,
in order to maximize the performance of the interaction. This makes tablets much more
similar to smartphones in functioning and interaction mode. Moreover they run a
similar operating system, usually based on iOS or Android, sometimes in customized
versions.
In a second time, Microsoft has introduced a substantial innovation with the release
of its Windows 8, an operating system designed to run both on traditional PCs and all
types of tablets.
Despite the differencies in operating system or manufacturer, tablets share many
features that make them recognizable:
1. High-definition display with a diagonal between 7 and 10 inches;
2. Wi-Fi or 3G/4G modules for Internet connection;
3. Applications (apps) supporting the performance of different activities (reading,
writing, games, social networking, video conferencing, chat, music, eBooks),
available (free or for a fee) on the related store;
Table 1. Comparison of the different tablet categories

Categories of tablet PCs
Slates Convertibles Hybrids
Tablets Mini Tablets Phablets
Screen size 9″–13″ 7″–8″ 5″–7″ 10″–13″ 7″–9”
Keyboard Via USB or BT Via USB or BT Via USB or BT Built in Detachable
Other Phone
4. GPS module for navigation and geo-referenced services;

5. Camera (usually less performing than smartphones ones);
6. Multi-touch screen that supports gestures;
7. Weight of about a kilogram or slightly less;
8. Variable battery life, still quantifiable in several hours (up to 12) of continuous use.
In order to understand why tablets could be the best device to encourage an audience of
elderly to use apps, the authors compare tablet with other devices able to run similar
applications: desktop PCs (or laptops), Smart TVs, smartphones.
In detail, tablets belong to the same family of smartphones, namely the mobile
devices. Unlike Smart TVs and desktop PCs, the context of use of mobile devices is
very variable, with environment and light conditions not always optimal. However,
tablets are still seen by most people as small computers rather than large phones. As a
consequence they are used to a great extent in domestic contexts. The possibility of
being regarded as technological knick-knacks, makes tablet preferred over smartphones
by elderly users. Indeed, smartphone devices are seen as cold and complicate, easily to
be lost and forgotten because of their small size. Tablets, instead, have a larger screen
that makes it easier to visualize information and to enjoy services, especially for an
audience with significant vision problems, remaining transportable at the same time.
The elderly can thus become inclined to the use of the tablet, even in a home
environment.
Actually also Smart TV could be considered as the preferred device for accessing
apps by elderly, since the latter makes large use of TV set. Moreover Smart TV offers a
wide screen, a control device (remote control) and a context of use (at a distance of a
couple of meters from the couch) familiar to the user. But Smart TV presents significant
interaction constraints when passing from watching the broadcasted video contest to
using apps, first of all due to the use of the remote control, familiar only for operations
such as channel switch or volume change [20]. In addition, the big screen offers a
non-optimal viewing distance for reading.
Focusing on the interaction mode, the touch screen interface typical of the tablet
represent a strong point over the other devices. The user is able to directly manipulate
the displayed objects of the interface, as it would happen in reality, by touching the
screen and moving fingers according to pre-established gestures (e.g. swiping the finger
on the display to change the page, as it occur on a paper book).
The interaction mode combined with the ease of use is the main strength of tablets
compared to traditional desktop PCs or laptops, which require the user to input data via
keyboard and mouse. In addition, because of their versatile nature, PCs run quite
complex operating systems, which require a lot of experience to be controlled by users.
4 Considerations and Suggestions
On the basis of the elements emerged from the related research studies and the analysis
of the framework (user needs and device features), the authors provide in this section
some considerations and suggestions about the design of tablet applications for elderly.
In detail, they identified 11 categories, providing different considerations for each of
them. Such considerations and suggestions can represent a useful reference for inter-
action designers during the design process for elderly-oriented tablet applications.
1. Services/Applications (the following is a not comprehensive list of possible
application fields): gaming (e.g.: for learning, entertainment or training); infor-
mation access; education; health care; working at home; community and social
relations; safety; monitoring.
2. Device: use slate devices with a screen size greater than 9″; use a pillar in order to
get users to arrange the tablet on a comfortable position to contain the glare glossy
screen problem (the optimum angle is 30°); use added accessories (rubber cases
with adjustable stands; screen protectors can help reduce glare).
3. Text: use a font size between 12 and 14 pt; use readable fonts, such as Sans Serif
fonts (e.g.: Arial, Verdana); use a single line spacing; avoid bold, underlining or
italics; avoid specific words (e.g. “nickname”, “FAQ”); repeat contents, avoiding
not key information; avoid capital letters, acronyms, and abbreviations; avoid scroll
text; use calibration systems (e.g.: word prediction, swabbing and automatic
correction).
4. Graphic aspects: use a sharp contrast between color background and text (in detail:
use dark writing on clear background); use a uniform texture; adapt object and
button size/dimension; use a border for pop-ups; use clear and concretes graphic
elements, avoiding the ones far from reality; use metaphors close to everyday life;
create coherent interfaces; design rich UI; offer an overview of the elements of the
interface; avoid moving UI elements; use multi-layered interfaces; develop the
applications in landscape (horizontal) view rather than portrait (vertical); maintain
a stable landscape; use a combination of labelling and icons; adequately separate
the different buttons; use explicit buttons rather than slider or cursor buttons.
5. Colours: prefer complementary colours in order to use a sharp contrast (e.g.:
orange and blue, white and black); use few colours; avoid pastel colours; avoid
blinding light.
6. Sounds: avoid sounds too quiet and blunted.
7. Command input: use single touch rather than multi-touch; use a voice interface;
design the interaction process with a specific gesture-based method, establish a
“hot area” around the buttons; use tactile input joined with haptic input.
8. Output: provide instant feedback (e.g.: after touching an icon, change colour); use
multi-sensorial feedbacks (e.g.: tactile feedbacks joined with/rather than sounds or
haptic output).
9. Basic features: combine touch-based and slide gesture interaction; use
adaptable/customizable setting/interfaces (customizable fonts, icons, combination
colours, button size, windows size, contrast level, sound level, on/off sounds,
vibration/haptic effects); use social features; guide users with tutorials, frequent
feedbacks, introductory videos on how use the application and the related tech-
nologies included into the device; use “help systems” (e.g.: frequently asked
questions, send a message with a question); use a stable menu interface, with a not
deep information architecture; focus application features and tasks; get user to set
technologies into application (e.g.: GPS, etc.).
10. Methodology: exploit co-design and participatory design to build a service

system/application; take data from users to determine the best method of grouping
content categories; involve users in evaluation processes of services.
11. Context of use: the better context of use of tablet applications should be home, with
the device on a desk and with the seated user.
5 Conclusions and Future Work
During the discussion of this paper, the authors investigated the issues concerning
possible interaction between the elderly and the tablets, aiming to understand whether
these devices can actually be, as many claim, the drivers that allow older adults to
enjoy interactive applications, at last.
The result of this study lead to the conclusion that by following a proper design
method it is possible to develop tablets applications that provide added value to users of
the target audience. So, she authors identify some suggestions in order to make the
design of tablet applications suitable for the elderly.
The next steps will be oriented to field test the effectiveness of the set out con-
siderations, which will be challenged in the implementation of specific projects and
applications. Moreover, will be taken into account and evaluated additional variables
connected to the context that affect the way users interact, such as public contexts.
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Developing New Gesture Design Mode
in Smartphone Use for Elders
Ming-Hong Wang(&), Yu-Chi Chang, Shuo-Fang Liu,

and Hsin-Hsi Lai
Department of Industrial Design, National Cheng-Kung University, Tainan,

Taiwan, ROC
{wming0403,hsinhsi6699}@gmail.com,
{liusf,hsinhsi}@mail.ncku.edu.tw
Abstract. This article is aimed to design new hand gesture mode of smart-
phone for better used by the elderly. The method first use focus grouping to find
out the most difficult use hand gestures for the elderly. Secondly, we develop
new gesture mode with one-finger gesture. Finally, we compare the traditional
gesture with new design gesture mode. Results show that (1) use two fingers as
gesture are the most difficult for the elderly; (2) new design mode are better than
traditional mode statistically significant in usability evaluation. Accordingly, we
suggest the new design gesture mode may be as one solution to substitute the
traditional gesture mode for the elderly.
Keywords: Hand gesture mode Smartphone design Focus grouping

Usability evaluation The elderly people
1 Introduction
With the rising in smartphone use in recent years, there have been many academic
studies on mobile phone use.
Nowadays, smartphone use is one of the study areas that should be explored and
invested. Many studies have shown that it is a big challenge for elderly people to use
smartphones, especially touch-screens. Because of factors related to aging in visual
acuity, aging of tactile perception, aging of cognitive ability and aging in motor ability.
Many studies mentioned that touch-screen user interface. Such as Guenther et al.
(2010) [1] compared with gesture inputting and traditional inputting, gesture inputting
interface is more efficiency; Kine et al. (2009) indicated that in selection task “one
finger direct-touch is faster than using a mouse and bimanual interactions are faster
than using one finger”; Park and Han (2010) [2] indicated that in regard to reaction
time, icon size design 10 mm is better than 7 mm and 7 mm is better than 4 mm [2];
And Piper et al. (2010) [3] compared with multi-touch inputting device and traditional
inputting device by interview survey, they indicated “multi-touch inputting device is
less intimidating, less frustrating, and less oppressive than a traditional computer”.
Gestures for human to human interaction are a natural and powerful tool of com-
munication. And it has instead speech communication in many situations (Seow et al.
2010) [4]. Charness et al. (2004) [5] and Rogers et al. (2005) [6] compared with direct

DOI: 10.1007/978-3-319-20892-3_50
520 M.-H. Wang et al.
input devices and indirect input devices (e.g. mouse or trackball), with respect to older
users have shown a general benefit of direct input devices over indirect ones. The direct
nature of gesture input thus might facilitate interaction for elderly. Therefore, it’s
necessary to avoid excessive wrist joint flexion and extension, continuous and rapid
movements, high coordination movements and to attention tactile perception feedback.
Gestural input interfaces are applying on many technical systems and it can be
classified roughly into 2D gestures, using finger or hand movement on touch-screens to
operate. And 3D gestures, using free-form movements in space to operate (Saffer,
2008) [7]. This study is focus on 2D gestures to explore better Smartphone operating
gesture for elderly.
However, the literature on elderly motor ability aging has documented a couple of
observations which might put the suitability of finger gesture input for elderly into
question, shown as Chaparro et al. (2000) [5] indicated that compared with two age
groups: the younger (aged 25 to 30) and the elderly (aged 60 to 69), the elderly wrist
joint flexion is decreased 12–14 %. Therefore, if included gesture input wrist activity
should be considered elderly wrist flexibility, judgment whether the gesture of the
elderly is a gracious gesture input. Walker et al. (1997) [8] indicated that the elderly
have less efficiency tactile perceptual feedback systems and lack the force to produce
very rapid movements. And Microsoft (2009) [9] indicated that the elderly are difficult
to conduct continuous moving task or the coordination of moving task.
The smartphone use is not conductive for the elderly. As of now, there still have
few studies on smartphone operating gesture designs for the elderly. Thus this study
takes an attempt to develop a new gesture mode of operating smartphone for elders.
To reach the aim of this research, three stages are adopted. In the first stage we use
focus grouping to find out the most difficult use hand gestures for the elderly. In second
stage, we develop new gesture mode with one finger gesture. In Final stage, we
compare the traditional gesture with new design gesture mode.
2 Method
2.1 Focus Grouping
• Sample products. The most sail products are used as samples in Taiwan market.
These include five brands smartphone, which are brand SS, A, H SN, and A. Please
see Fig. 1.
• Subjects. Five individuals older than 60 (Mean = 63.2; female = 2, male = 3) with at
least one year previous smartphone use experience were found to explore and
discuss smartphone operating gestures of five brand sample products that might be
suitable for the elderly.
• Process. Initially, a host provides subjects with five brand sample products and
shows them how to do gestures of different sample (with 30 min.). Then let each
subject to operate them (with 30 min.) in order to determine which smartphone
operating gesture is the most difficult for the elderly, and the top three most difficult
gestures become the main research core (with 60 min.).
Developing New Gesture Design Mode in Smartphone Use for Elders 521
Fig. 1. Five brands are used as sample products
2.2 Developing New Gesture Mode

First, a team consisted of five designers with at least 6-year product design experience
are organized to find feasible solutions (with 2D sketch drawing) to solve operational
difficulty of two-finger gesture for the elderly using smartphone. Then 10 elders are
invited to evaluate feasible solutions and choose best new solution for the designer
team to develop computer simulation.
2.3 Usability Evaluation of New Design Gesture Mode

This research uses usability evaluation to compare traditional gesture with new designs.
Usability evaluation include five sector indexes as the following:
1. Learnability-ease to learn and learning quickly.
2. Efficiency-efficient to use and after learning, then quickly to reach high efficiency.
3. Memorability-easy to memorize and casual user can operate immediately, no need
to learn again.
4. Errors-lower error rate.
5. Satisfaction-total feeling of usability to satisfy the operation.
Experimental procedure follows three steps. First, three experimenters teach subjects
how to operate traditional smartphone and new gesture design mode. Second, all
subjects practice till they familiarly to use traditional smartphone and new design
mode. Finally, all subjects answer the questions of usability evaluation.
3 Result
3.1 Result of Focus Grouping

The final summary of focus grouping is the top three most difficult gestures for elders
are rotate gesture, zoom in gesture and zoom out gesture (refer to Figs. 2, 3 and 4). The
reason is two-handed gesture is too messy and that multi-finger gestures are sometimes
not so easy for elders.
Fig. 2. Zoom in gesture (shrink)
Fig. 3. Zoom out gesture (enlarge)
Fig. 4. Rotate gesture
3.2 Result of Developing New Design Gesture Mode

Two new design gesture mode are built (please see Figs. 5 and 6). The character of new
designs is singer-finger gesture that is easier to operate than multi-finger gesture for
elders, according to the result of focus grouping (Figs. 7, 8 and 9).
3.3 Result of Usability Evaluation to New Design Gesture Mode

Tables 1 and 2 show that ND 1(New Design Gesture 1) is the best gesture mode and
reach to statistical significant (P < 0.05) in usability evaluation which includes 5 items
Fig. 5. Zoom in (slide down gesture new design 1)
Fig. 6. Zoom out (slide up gesture new design 1)
Fig. 7. Zoom in (reverse clock circle gesture new design 2)

Fig. 8. Zoom out (clock circle gesture new design 2)
Fig. 9. Rotation (slide up and rotation gesture new design 3)
Table 1. Mean and S.D. in different gesture mode
Evaluation items
Learnability Efficiency Memorability Errors Satisfaction
number 30 30 30 30 30
TR Mean 3.80 3.43 3.40 3.37 3.13
S.D. 0.407 0.626 0.498 0.669 0.730
Gesture number 30 30 30 30 30
mode ND1 Mean 4.40 4.30 4.00 4.30 4.70
S.D. 0.675 0.651 0.643 0.466 0.466
number 30 30 30 30 30
ND2 Mean 3.30 3.50 3.80 3.20 3.80
S.D. 0.651 0.509 0.761 0.407 0.761
(learnability, efficiency, memorability, errors and satisfaction). However, ND 2

(New Design Gesture 2) is only better than traditional gesture mode in regard to
usability evaluation in 3 items (efficiency, memorability and satisfaction).
Table 2. Comparisons in usability evaluation Font sizes
(J) Comparison
Variable (I) gesture Standard error Significance
gesture result
ND2 0.152 0.000
ND 1
TR 0.152 0.001
ND1 0.152 0.000
Learnability ND2 ND1>TR>ND2
TR 0.152 0.006
ND1 0.152 0.001
TR
ND2 0.152 0.006
ND2 0.155 0.000
ND1
TR 0.155 0.000
ND1 0.155 0.000 ND1>ND2>
Efficiency ND2
TR 0.155 0.911 TR
ND1 0.155 0.000
TR
ND2 0.155 0.911
ND2 0.166 0.487
ND1
TR 0.166 0.002
Memorability ND1 0.166 0.487 ND1>ND2>
ND2
TR 0.166 0.060 TR
ND1 0.166 0.002
TR
ND2 0.166 0.060
ND2 0.136 0.000
ND1
TR 0.136 0.000
ND1 0.136 0.000 ND1>TR>
Errors ND2
TR 0.136 0.474 ND2
ND1 0.136 0.000
TR
ND2 0.136 0.474
3.4 Result of Rotation New Design in Usability Evaluation

Table 3 shows that rotation design gesture (RN1) is better than traditional gesture
(TR) in all aspects of usability evaluation and all reach statistical significance.
Table 3. statistical result of rotation new design gesture in usability evaluation
Effecttive evaluation items

Leanabity Efficiency Memor
Errors Satisfaction
ability
Number 30 30 30 30 30
TR Mean 2.6 2.3 3.0 3.2 2.7

Rotation
S.D. 0.81 0.65 0.45 0.61 0.91
gesture Number 30 30 30 30 30
mode
RN
Mean 4.4 4.6 4.0 4.6 4.6
1
S.D. 0.93 0.93 0.78 0.67 0.93
F value 63.5 122.7 36.3 71.1 63.4
P value (significance) 0.00 0.00 0.00 0.00 0.00
Compare result RN1>TR RN1>TR RN1>TR RN1>TR RN1>TR
4 Conclusion and Further Study
Given the analysis results, this study suggests that the elderly aged 55 up may use new
design mode (ND 1) with single-finger operating gesture as a smartphone operating
gesture mode. These results also contribute to further study intended to develop an elderly
touch-screen user interface. Finally, this study expects to be an entry point by which to
explore more suitable way to make smartphone use more accessible for the elderly.
Further study will focus on motion analysis on muscle fatigue and joint anger vary
of finger gesture and tracking eye movement of finger gesture to new design mode.
These study will scientifically prove that the new design gesture mode is really better
than traditional one.
Acknowledgements. The authors would like to appreciate that this research is financially
supported by MOST (Ministry of Science and Technology) at Taiwan, R.O.C, under the project
number: MOST 103-2221-E-006 -214 -. All invited subjects and designers are also appreciated
very much.
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Research on Interaction Design of Intelligent
Mobile Phone for the Elderly Based
on the User Experience
Minggang Yang(&) and He Huang(&)
School of Art, Design and Media,

East China University of Science and Technology, M. BOX 286,
NO. 130 Meilong Road, Xuhui District, Shanghai 200237, China
{yangminggang,1983222hh}@163.com
Abstract. Whether in the developed or developing countries, aging of popu-

lation has been a common global trend. With the development of the commu-
nication technology and the Internet era of prosperity, the elderly people also
inevitably need to use modern communication products such as mobile phone so
that they could keep contact with their family, children, the outside world,
including quick call in case of an emergency etc. But the physiology and psy-
chology of the elderly are very different from the young people, which mainly is
reflected in the degradation of vision, hearing, touch, reaction ability, hand
strength, text and graphics memory ability and so on. Thus when the elderly
people are using the mobile phone there are a lot of inconvenience and special
requirements by them and the user experience is also far different form the other
age groups. Therefore, in the design of the mobile phone for the older age
groups whether the appearance design or the interaction design should reflect on
our care for this special group, to improve the usability of the product, to bring
convenience for them. This paper firstly studies the physiological and psycho-
logical characteristics of the elderly. Then it analyses the behavior characteristics
of the elderly in the use of mobile phone and the user experience. Moreover
some principles and methods of interaction design for the elderly mo-bile phone
are presented in this essay; Additionally through several practical cases of the
mobile phone design for the elderly in China and by using the research method
such as the user behavior analysis, user survey, Analysis of the availability of
products, product evaluation, this paper will analyze and summarize the short-
comings of the current mo-bile phone for the elderly in interaction design.
Finally this paper will not only point out the direction of improvement for the
elderly mobile interaction design but also provide some useful suggestions and
enlightenment for the elderly mobile phone design in the future.
Keywords: Interaction design The elderly mobile phone User experience
1 Introduction
The application and development of digitizing have made new demands to mobile
phone interaction design and other fields constantly. Mobile phone has become a smart
media tool which help people communicate with others release news and express
DOI: 10.1007/978-3-319-20892-3_51
Research on Interaction Design of Intelligent Mobile Phone 529
personal views in 21th century when it was a kind of ordinary communication tool in
the late 20th century. In one hand, Phone as a new media into our lives, it has both
information dissemination functions, but also has editing functions of information, its
function determines the phone has a very wide range of user groups. In the other hand,
with the advent of the era of Chinese society aging, older products, particularly
growing demand for mobile phones. How to use information technology to improve the
quality of life of older persons to researchers, developers, community managers, market
players are needed to solve a problem, it has both a large market potential and eco-
nomic significance, but also has great social significance and cultural value.
2012 is the Chinese smart-phone outbreak, the use of smart phones have entered the
vast majority of Chinese families. Smart-phone is the use of touch-screen technology,
the technology is applied to a type of mobile phone handset screen above. The greatest
feature is its large screen that you can make to bring visual enjoyment, whether text or
images from aspects reflect the characteristics of the big screen. There are currently a
lot of smart phones on the market, but it is not suitable for the elderly, through surveys
and studies have found that older user experience research has been at a relatively low
level. Currently, there are many shortcomings for older smart-phones. Relatively small,
such as font, icon is relatively small, there is a complex operation, for main-stream IOS
and Android operating systems, elderly or inconvenient to use. Therefore, upgrading
older smart-phone interaction design is very important.
This paper focuses on the interaction design of smart phones for the elderly, based
on a sense of how to improve the experience of interacting with older smart-phones. To
sum up, the paper work and the main results obtained are as follows: 1. based on the
relevant literature to define the user experience, interaction design, older smart-phone
concept. 2. through research and analysis in the form of user interviews and ques-
tionnaires, the results of the interaction of many factors that affect the elderly smart
phone design, and described from four users, behavior, technology and scenes. 3. the
older design of the smart-phone user experience is divided into three layers, namely,
the experience level of human caring, emotional care experience level, transcendent
experience level, and targeted research on the characteristics of these three experiences.
4. finally, discusses the strategies and recommendations to enhance the older
smart-phone interaction design.
In this paper, the elderly smart-phone for the study, theoretically designed to enrich
the user experience as the core of the interaction de-sign study for the integration of
technology and art filled with more possibilities bridge erected in practice to businesses
and designers to provide a reference.
2 Research Background
With the improvement of people’s health and life expectancy of the population, the
elderly account for a growing proportion of the population in China in recent years, the
concept of healthy aging in-creasing attention from the international community. The
United Nations, the healthy aging as a global goal to address aging issues.
International definition of the elderly are not uniform, usually 60 or 65 years of age
or older citizens regarded. By the end of 2011, the Chinese elderly population aged 60
530 M. Yang and H. Huang
and above has reached 185 million people, 13.7 percent of the total population.
A longer period of time in the future, the proportion of the elderly population will
average 3.2 % growth rate in 2020, the elderly population will reach 248 million, the
level of aging will reach 17.17 %, of which, 80 years old and older population will
reach 3067 million, accounting for 12.37 % of the elderly population.
At present, China’s number of mobile subscribers has more than 960 million, of
which smart mobile terminal growth trend showing violent. Chinese smart phone users
accounted for 33.9 % share of the global smart phone, smart phone users in China the
proportion of people over the age of 45 and gradually increased, as of the end of March
2013, this group accounted for 7.1 %, up 3.5 percentage points higher than the end of
2011. The absolute number of elderly Chinese smart-phones are weak, although in all
age groups, but its growth rate is impressive.
According to the middle-aged group of professional survey results reflect, in which
the middle-aged group, 60-year-old former people, 85.59 % have a mobile phone, but
62.38 % over a two-year service life; parents of children with a cell phone from
52.25 %, which a large part of the children out of product, 45.38 % of respondents
intend to replace parents/buy mobile phones; nearly 69 percent of people think that
there is little old mobile phones on the market, so the 67.8 % of the elderly welcomed
the phone; the main product information Get through the Internet, 48.48 %, 43.94 % is
searching through the store; 70.37 per-cent choose to purchase traditional stores,
selected by the network to buy 19.75 %, 9.26 % choose phone orders only.
Looking at the current mobile phone market, although many varieties, but the use
of smart phones for the elderly, but very few. At pre-sent, the smart phone market also
belong to the elderly incubation period, the low-end market is mainly dominated by
older machines, old ordinary phone call can solve the basic needs of the elderly, but can
not meet the fashion of the elderly for health, recreation and social demand,
smart-phones complex operation, is still the biggest obstacles to the elderly to use.
Due to the aging of bodily functions and the consequent changes in mental aging
makes use of smart phones for the elderly constitute a significant obstacle. Due to the
aging of the body, slowing the elderly brain reaction speed, sensory organs and organ
function decline movement, so they fall on the ability to learn new things, reduced
ability to coordinate action, seeing and hearing decline. Overall, the obstacles Chinese
elderly smart-phone include: physical, mental, skills, services and economic barriers.
Mainly in the following areas: Content smart-phone display text, especially for the
elderly seem difficult; smart phone operating mode for the elderly is not very appli-
cable; realize the functions of the smart phone is not intuitive, but to go through
learning. In summary, the barriers older people use smart phones mainly on
smart-phones and human interaction, to overcome these obstacles, we must take into
account the common characteristics of older users, starting from the interactive mode,
based on user experience design ideas applied to interaction design for smart phones in.
Therefore, from the perspective of the user experience, based on the behavior of the
elderly and psychological research, as well as the basis for understanding the context of
the elderly to use, to explore the experience of older smart-phone design factors
conducive to design a truly meet the elderly are particularly smart-phones important.
3 Literature Review
User experience is the user in the use of a product or a service in an interview, with
their own experience built up a feeling both physical and psychological, including.
Field of study abroad in the elderly mobile phone user experience interaction
design focused on appearance, function, development and usability, and more and more
attention and depth. For example, Sanches Lam (2009) used a variety of methods to
confirm the elderly have to use smart phones for learning needs and interests. British
Sri Kurniawan (2006) study found that mobile phone design through face problems in
the elderly, as well as suitable for the elderly phone “good interface” with the char-
acteristics. Malaysia Hazrina Hassan, Mohd Hairul Nizam Md Nasir (2008) study in
the elderly mobile phones mainly in older handsets look and functional design.
Wonkyu Park (2011) propose a systematic methodology to derive broad design
guidelines for mobile user interfaces, and verified through a case study of the method
are summarized in three key factors derived using the method that the general usability
criteria, the user interface components and the development of principles and guide-
lines attributes, user interface designers this method can be used to develop and
improve the standard and standard phone interface. Karen Renaud and Judy made in
the elderly mobile phone handset design, attention should shortcuts design, streamline
operations, user-centric. Hartmut Wandke and Lucienne Blessing designed a set of
experiments designed the 42 non-contact interaction actions were a certain number of
elderly and young people compared comparison found complete accuracy of these
actions elderly and young people and there is not much difference, which is slower than
on the completion of young people.
Chinese elderly mobile phone interaction design is still in its infancy. Yang Jingjing
(2008) to the elderly mobile phone design, for example, a mobile phone for the elderly
and attitude survey of existing multi-function mobile phones is reasonable analysis. Wu
Xia, Wu Chao (2009) using the ergonomic and cognitive psychology theory, a design
approach to the elderly as the center of the man-machine interface, and make the phone
better services for the elderly, people and machines real match. Zhou Yu, Dong Jixian
(2009), Yang Yakun (2013) for the multi-functional mobile phones currently on the
market phenomenon, the modular design method is introduced to solve the elderly
handset design capabilities waste, pointing out the necessity of product function
properly designed. User research Peng Jia (2013) to the elderly smart-phone APP
interaction design interface for the study, health aides APP interface design, for
example, confirmed that the interface design process should always carry out the user
experience-oriented, not only have a thorough preliminary design profound insight into
the needs of users, the latter should also be repeated user testing. Sun since Tudor
(2014) believes that the smart-phone complex operation, is still the biggest factor
impeding the elderly to use in intelligence, we should be simplified for the physio-
logical characteristics of the elderly, operating practices, so that the elderly will be able
to learn to use short, manufacturers need to overcome the problem.
In summary, the present study abroad interaction design more mature, smart phones
for the study of interaction design practice focused, practice and technology devel-
opment, but there are still problems, interaction design research for the theory to a
third-party application design guide books still less. There are currently no systematic a
good way to help the elderly mobile phone designers to design development and
evaluation, theoretical and applied research on older mobile phones to interact intel-
ligently designed room for improvement there.
4 Research Methods
4.1 The Main Research Methods of this Paper
The first one is the multidisciplinary research method. The content framework of this
paper uses interdisciplinary knowledge system interaction design to construct the
elderly intelligent mobile phone, enriches the connotation and direction for the tradi-
tional interface design. First of all, by using the knowledge of user psychology analysis
of hierarchy of needs, the application needs to try to satisfy higher level of the hier-
archy of needs to make the user to generate sustained and strong point of application;
secondly, try to concept study of the elderly interaction design in intelligent mobile
phone using psychology, aesthetics, art design.
The second one is the research method of literature. This paper studies the trans-
lation and collected books related to mobile internet interaction design and old product
design and design aesthetics, psychology and information, research for the elderly
intelligent mobile phone interaction design content, method, characteristic, sorted out
and analyzed; the contents of each part system adopts the inductive method for the
elderly intelligent mobile phone interaction design re organization; at the same time,
through the comparison and analysis of literature, obtains the product user centered
design methods, should be closely combined with the analysis of market environment
and competitive factors, choose more paths and methods suitable for the elderly
intelligent mobile phone interaction design.
The third is to study the method of model. Through analyzing the user needs of the
elderly level relationship between the induction intelligent mobile phone applications,
the research proposes the user cognition, behavior and emotion model, and emphasizes
the designer models need to be as much as possible match the user model, so as to
make the application in accordance with the user’s psychological expectations.
4.2 The Specific Research Method in this Paper

The first is the user observation and interview method. According to the basic infor-
mation of the user and a mobile phone with health related topics, user interview,
observation method combined with observation of user behavior, to existing products
operation, confusion and problems encountered in the process of using record, analyze
user cognitive model, behavior habit and other elements.
The second is the qualitative and quantitative research method. Qualitative research
is mainly user interview, quantitative research is mainly a questionnaire survey method.
The third is the personas method. According to the interview and questionnaire
survey results, user goal definition, including the target task, mental model and
behavior pattern.
The fourth is the objective oriented method. In determining the older users put
forward the promotion strategy and suggestions on the basis of intelligent mobile
phone demand, interaction design, information including hardware and software
interaction design and interactive experience design.
5 Result
5.1 Research on the Influence Factors of the Elderly in Intelligent Mobile
Phone Interaction Design
The elderly is the target user of the study, they are exactly different from the young in
physical, mental health and behavior. So in order to design intelligent mobile phone
conforms to the characteristics of the elderly, we must understand the differences
between them and the young people first. This difference is one of the key to solve the
elder’s difficulty in learning using intelligent mobile phone.
The main effect of design of the intelligent mobile phone interaction is the user,
behavior, technology, environment and other factors.
User impact factors. Changes in physiology of the elderly is mainly reflected in its
perception system. For example, physiological changes in the elderly in the visual
aspects mainly: presbyopia, color change, physiological Ming and dark vision changes,
the decrease of contrast sensitivity, glare sensitivity of vision and depth perception,
smaller weakened etc.
The behavior influence factor. The old man’s hand is the most important part for the
operation of the mobile phone, but the hand of each joint with age aging gradually
become rigid, inflexible, maybe even a trembling.
Technical factors. The elder people is lack of knowledge of science and technology,
they do not quite understand some of the application and proper nouns in the language
to describe the function, in the process of using intelligent mobile phone will usually
appear confusion, frustration.
Scene influence factors. When the aged used interactive scene changes, elder
people may feel unable to adapt to the changes, and even affect the use of mobile
phone.
5.2 The Elderly Intelligent Mobile Phone Interaction Design User

Experience Level Model Construction
Interaction design of mobile phone is mainly to solve the interaction process and
information architecture and design, including menu design, hardware interface defi-
nitions and interactive design documentation. The author will be elderly intelligent
mobile phone interactive user experience design experience, emotion experience, care
for humanity transcending experience level model.
The first human caring experience level. On the basic of interaction design prin-
ciples, intelligent mobile phone for the elderly to humanity is: simplicity, respect,
friendly user feedback, consistency. One is simple. Interactive design of the elderly a
smart phone interface: no need to learn, one will see two seconds of wait time,
operating within step three. The two is to respect the user. In the real life of common
element applied to the elderly the Smart phone application interface design. Three is the
friendly feedback. To provide the elderly immediate and positive feedback, according
to different circumstances difference design. Four is the consistency. Consistent visual,
elderly intelligent mobile phone function, information architecture, operation mode.
For example: the expression of interface function should also try to match the elderly
cultural knowledge, so that the elderly can quickly understand and operate.
Beyond the experience level again. After investigation and analysis, the charac-
teristics of intelligent mobile phone that older users is one of the most critical is the
personification of remote interactive, intelligent, caring. The first one is personification.
For natural interaction through language, gestures, facial expressions, gaze and body
language. The second one is the remote interaction. With the intelligent mobile phone
based mobile intelligent terminal, in a whole new way to interact. The third one is the
smart care. Through the intelligent mobile phone positioning real-time understanding
of the position of the elderly and health.
5.3 Elderly Smart-Phone Interaction Design and Recommend Strategies

to Enhance
Elderly smart-phone interaction design is to allow the elderly more quickly, simply and
efficiently operate the phone. On the one hand we realize the function; on the other
hand we must also get pleasure visual, auditory, tactile and psychological. For example
ITT Easy 5, Jitterbug Touch, Life Plus, Doro HandleEasy 330GSM, Emporia Connect,
Raku Raku (F-12D), NOKIA X (RM-980), Hisense E360M, obooy EA508 elderly and
other smart phones. It includes hardware and software interaction design, information
design and interaction design interactive experience. Its promotion strategy and rec-
ommendations are as follows:
The interaction design of hardware is the need to pay attention to the following
aspects. The first is handset size. In determining the scale of older phones, designer
ergonomic reference to the definition of the best features of size: the size of the best
features of the human dimension percentile = + + psychological correction function to
correct the amount of volume. The sizes of the phone within 110 × 84 × 18 mm, the
elderly in order to meet the requirements of scale. The Second is the key size. The size
of the older phone keys, thumb finger widest, ac-cording to this size, the higher the
accuracy of the size of the phone keys, take fifty percentile: 21 mm. Hand of freedom
has a certain range of factors in this regard attention should be designed in older
phones. The last is volume. According to the previous analysis and the elderly affect
the physical and psychological characteristics, when designing the sound, not only to
consider whether to listen carefully to the elderly, but also need to consider the impact
of the size of the sound on vision. Set the size of the sound into an adjustable mode, the
maximum volume can be designed to 70 db, 70 db above may cause damage to hearing
on the elderly. While ensuring clear sound clear, gentle not harsh, especially voice
prompts operation, should bring clear message reminders and feedback to the elderly.
About software interaction design should pay attention to the following aspects one
simple smart-phone. Have the following functions: First Call functions: designed to
loud and clear, the best talk in a noisy environment also affected the pattern. Second
Ring features: ringing loud and in accordance with the elderly hobby, it is best oldies
and classic drama. Third, the text input function: the key input method based, voice or
handwriting supplement. Pinyin input method selection or stroke input method. Fourth
Display: Screen color soft and easy to identify, soft interface font larger. The second is
in the end smart-phones. In addition to these functions, but also includes the following
four functions: First radio function: can receive more channels, the effect is more clear
and better. Second alarm: Tone big, it is best voice broadcast to remind time and
content. Third, the memo: Voice memo reminding content, such as rationing medi-
cation such matters. Fourth Call Alert: voice reminder, speed to slow, soft and clear
voice. Set caller photo display. The third is about the high-end intelligent mo-bile
phone. This phone addition to the above features, but also includes the following three
functions: First, the entertainment features: Set chess and mahjong games, MP3, for old
people listen to music, theater and entertainment purposes. Second, the calculator
function: designed to be simple model suggested by way of handwriting input, and can
deliver results fast, easy and convenient to use when computing for the elderly. Third,
GPRS positioning function: to determine the location of the elderly, in time to help
families find lost, lost in the elderly. Other features: health care software, physical
exercise software, flashlight function.
Several aspects of information interaction design, one reasonable arrangement
density information of the project. Need to design a suitable way to highlight the key
information that is adjustable font and icon arrangement. Second, should use the user’s
language to convey information, rather than the language technology. Third, make the
font size, color, icon design focus on symbolic. Fourth boot animation, consistent detail
and intangible elements of the framework. Fifth avoid the same element that contains
too much information.
On improving the experience of interaction design has the following strategies and
suggestions. First let older users control interactive process, “Next”, “Finish” button.
Secondly, Interactive experience de-signs to have a certain commonality and intelli-
gence, to help or hints for older users operating role. Third icons, multimedia design,
detail design and additional features designed for older users to experience the value,
effectively enhance the experience degrees. Fourth visual design, for example, switch
machine animation, interface display effects. Fifth older users consider the privacy of
information, providing effective protection mechanisms, such as a fingerprint to unlock,
unlock graphics, digital unlocking.
6 Conclusions and Discussion
Elderly smart-phone user experience based on interaction design is to design

user-desired goal, to meet user demand for the product of emotional experience.
Elderly smart-phone interaction design focuses on simplicity, simple interface, easy
to identify with buttons to ensure older people can be spotted in any case to see
stability.
Emotional experience of the elderly should be based on its function, given the
emotional content of products, and through the “form of love,” allowing users to feel a
certain emotional satisfaction. “Emotion-ally moving” is the key to emotional expe-

rience, the taste of the appearance, intimate functions, is the key to enhance the
emotional experience of older smart-phone design.
Elderly smart-phone is necessary to meet the child needs for care and love their
parents, but also realize the emotional communication between parents and children,
especially in the strong emotional appeal when parents participate in patency between
the old and the phone, the phone with their children, is very important.
Elderly smart-phone design study investigated sensory effects not only the elderly,
but also to fully relate to a specific mobile application interaction processes, and other
aspects of experience, complete mobile Internet ecosystem is intelligent hardware,
operating systems and third-party applications the composition, of a portion of the
adverse experience will affect the user experience across the elderly.
In short, the elderly smart-phone user experience, interaction de-sign, based on the
requirements in the design is closely integrated with the elderly, the elderly needed
attention, understanding the elderly emotion. For the elderly in order to meet the basic
requirements on product functionality, interactivity and focus on the emotional expe-
rience of the elderly to the technical support, the closer to the man-machine from
design better and more humane interaction works.
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Author Index
Abdullah, Mohammed II-377 Chalkia, Eleni I-157

Adams, Anne Edith II-278 Chan, Alan Hoi Shou I-239, I-273
Ahmed, Pervaiz K. I-273 Chang, Chia-Ling II-201
Al Ehaidib, Reem II-367 Chang, Teng-Wen II-533
Al-Hajjar, Dua’a II-367 Chang, Wan-Ling I-104
Allaire, Jason C. II-61 Chang, Yu-Chi I-519
Almeida, Nuno II-146 Charness, Neil I-262, II-3
Al Muhanna, Sarah II-367 Chaumon, Marc-Eric Bobillier II-237
Al-Sharawy, Ibraheem II-377 Chen, Hongtu II-50
Al Sohibani, May II-367 Chen, Ke I-239
Al-Wabil, Areej II-367 Cheong, Soon-Nyean I-273
Aly, Shady II-377 Choi, Sang D. II-333
Aman, Frédéric II-341 Choi, Young Mi II-222
Arfaa, Jessica I-297 Chou, Chien-Ying I-317
Arning, Katrin I-282 Chourasia, Amrish I-307
Christodoulou, Eleni II-257
Bajcsy, Ruzena II-101 Clune, Stephen II-170
Becker, Stefan II-123 Colombo, Fausto I-166
Beer, Jenay M. II-446 Compagna, Diego I-26
Bekiaris, Evangelos I-157, I-387 Comunello, Francesca I-439
Belk, Marios II-257 Cotten, Shelia R. II-389
Belotti, Francesca I-439 Coventry, Lynne I-250
Bennett, Casey C. I-104 Cros, Florence II-237, II-399
Benveniste, Samuel II-158 Cuvillier, Bruno II-237, II-399
Berdal, Sondre II-435
Berkowsky, Ronald W. II-389
Dalin, Rolf I-123
Best, Ryan II-3
Danesh, Ali II-247
Blackwell, Alan F. I-73
Daraei, Sara II-456
Blair, Lynne II-170
Day, Rong-Fuh I-317
Blusi, Madeleine I-123
Dehoff, Peter II-193
Bobeth, Jan I-134
Demiris, George II-114
Bobillier-Chaumon, Marc-Eric II-399
Dias, Miguel Sales II-257
Body-Bekkadja, Salima II-399
Ding, Yao I-307
Boletsis, Costas II-15
Djamasbi, Soussan II-479
Bolle, Sifra II-27
Doh, Michael I-177
Bradshaw, Jessica II-211
Dong, Hua I-44, I-61, I-84
Brauner, Philipp II-423
Doty, Tracy Jill II-412
Cabral, Vanessa I-414 Drescher, Toni I-414
Calero Valdez, André II-38
Carlo, Simone I-166 Einstein, Gilles O. II-82
Carrillo, Ivan I-15 Ekström, Maria I-35
538 Author Index
El Saddik, Abdulmotaleb II-247 Joshi, Suhas Govind II-435

Ertl, Thomas I-325 Jung, Tzyy-Ping II-412
Fernández-Ardèvol, Mireia I-189, I-439 Kacmar, Allison A. II-446

Foo, Schubert I-484 Kaiser, Eva II-290
Källström, Mathias II-435
Galindo, Gilberto I-15 Kallus, K. Wolfgang II-354
Gandy Coleman, Maribeth II-61 Kbar, Ghassan II-377
Gao, Shang I-451 Kellihan, Bret II-412
García-Canseco, Eloisa I-15 Kerssens, Chantal II-278
Gemou, Maria I-387 Kirchhofer, Tim II-290
Germani, Michele II-311 Knott, Camilla C. II-278
Ghovanloo, Maysam II-222 Kohlbacher, Florian I-26
Githens, Steve I-307 Krogstie, John I-451
Glaser, Tobias I-426 Ku, Wen-Tsung II-89
Gomez-Gurley, Keiko II-61 Kumar, Renu II-278
Good, David A. I-73 Kurakata, Kenji I-94
Gorce, Philippe I-463 Kurillo, Gregorij II-101
Gorman, Paul II-101
Grimaldi, Roberta I-509 Laamarti, Fedwa II-247
Lafontaine, Constance I-210
Hakken, David I-104 Lai, Hsin-Hsi I-519
Hallwirth-Spörk, Christina II-193 Landmark, Brynjar Fowels II-15
Hanke, Sten I-134, II-257 Lang, Dieter II-193
Harrington, Christina N. II-488 Lazar, Amanda II-114
Harris, Maurita II-211 Leckebusch, Judith I-414
Hartley, Jordan Q. II-488 Lee, Jeannie K. II-82
Henka, Alexander I-325, II-465 Levkoff, Sue E. II-50
Herbolsheimer, Florian I-177 Li, Yi-Chang I-221
Hildebrandt, Julian II-423 Lian, Jiunn-Woei I-347
Hodgins, Diana II-72 Liao, Chien Hsiang I-230
Holland, Caroline I-201 Liles, Karina R. II-446
Holland, Temika I-475 Lin, Hsuan II-201
Hsieh, Hsiu Ching Laura II-269 Lin, Yu-Chin I-398
Hsieh, Pi-Jung II-89 Lindholm, Kim II-324
Hsu, Chi-Hsien II-524 Litvan, Irene II-412
Hsu, Yeh-Liang II-324 Liu, Shuo-Fang I-519
Huang, He I-528 Liu, Wei I-53
Huang, Jincheng I-337 Lo, Kung-Chih II-524
Huang, Shan I-44 Loos, Eugène F. I-35, II-27
Lorenz, Dieter II-193
Ingrosso, Andrea I-509
Lund, Henrik Hautop II-500
Insel, Kathie II-82
Lutherdt, Stefan II-290
Itoh, Nana I-94
Iualè, Matteo II-311
Ivan, Loredana I-189 Ma, Qi I-239
Madrid, R. Ignacio I-157
Jiang, Ying I-61 Mao, Mao I-73
Jimison, Holly II-101 Marcoe, Jennifer II-101
Jochems, Nicole I-365 Marin Mejia, Angie L. II-300
Jokisch, Mario I-177 Martins, Ana Isabel II-146
Author Index 539
Mayer, Christopher I-134 Riedel, Till I-387

McCallum, Simon II-15 Rigaud, Anne-Sophie II-158
McCarthy, Ian II-72 Rikard, R.V. II-389
McLaughlin, Anne Collins II-61, II-211 Rogers, Wendy A. I-262, I-354, II-3, II-278,
McNeill, Andrew I-250 II-488
Meinedo, Hugo II-257 Romano Bergstrom, Jennifer I-354
Mengoni, Maura II-311 Rosa, Ana Filipa II-146
Mertens, Alexander II-123 Rossato, Solange II-341
Meza-Kubo, Victoria I-15
Mitzner, Tracy L. I-262, II-3, II-488 Šabanović, Selma I-104
Moget, Caroline II-158 Sagawa, Ken I-94
Monfort, Emmanuel I-496 Samaras, George II-257
Morán, Alberto L. I-15 Sandner, Emanuel I-134
Morrow, Daniel G. II-82 Sanford, Jon A. I-115
Mortazavi, Siavash II-479 Sawchuk, Kim I-210
Mostafazadeh, Aida II-456 Scandurra, Isabella I-123, II-181
Motti, Lilian Genaro I-463 Schlick, Christopher II-123
Mulargia, Simone I-439 Schmidt, Laura I. I-177
Schwarz, Stephanie I-134
Natemeyer, Hendrik I-282 Sciarretta, Eliseo I-509
Nazari Shirehjini, Ali Asghar II-456 Sebastian, Jeffrey II-324
Nazzi, Elena II-512 Sengpiel, Michael I-365
Ning, Weining I-84 Sharma, Dhruv II-170
Shojaeizadeh, Mina II-479
Ofli, Ferda II-101 Sili, Miroslav I-134, II-257
Ohyama, Junji I-94 Silva, Samuel II-146
Oliveira e Silva, Miguel II-146 Sjölinder, Marie II-181
Olmsted-Hawala, Erica I-354, I-475 Smets, Ellen M.A. II-27
Opromolla, Antonio I-509 Smirek, Lukas II-465
Östlund, Britt I-3 Sokoler, Tomas II-512
Owens, Otis L. II-134 Souders, Dustin J. II-3
Özalay, Baris I-282 Sourbati, Maria I-376
Stiegler, Andreas I-145, I-325
Pang, Natalie I-484 Stratmann, Annkristin I-426
Panou, Maria I-387 Stuck, Rachel E. II-446
Pavel, Misha II-101 Sust, Charlotte A. II-193
Pereira, Carlos II-146
Peruzzini, Margherita II-311
Tai, Chih-Yin II-324
Piatt, Jennifer A. I-104
Taveira, Alvaro D. II-333
Picard, Robert II-158
Teh, Pei-Lee I-239, I-273
Pino, Maribel II-158
Teixeira, António II-146
Portet, François II-341
Theis, Sabine II-123
Portugal, David II-257
Thompson, Hilaire J. II-114
Qu, Yanrui I-53 Tobias, Jim I-307
Quillion-Dupré, Lisa I-496 Touliou, Katerina I-387
Quintas, João II-257 Tsai, Wang-Chin II-201, II-524
Rasche, Peter II-123 Vacher, Michel II-341

Reeß, David I-426 van Weert, Julia C.M. II-27
Rialle, Vincent I-496 Vanderheiden, Gregg I-307
540 Author Index
Vigouroux, Nadine I-463 Wu, Xiaolong II-222

Volpi, Valentina I-509 Wu, Yi-Sin II-533
Vu, Samantha I-484
Yang, Minggang I-528
Wagner, Verena II-354 Yang, Yuhao I-451
Wahl, Hans-Werner I-177 Yap, Wen-Jiun I-273
Wang, Huilin I-337 Yuan, Shu I-61
Wang, Ming-Hong I-519
Wang, Ming-Wei I-398 Zao, John K. II-412
Wang, Yuanqiong (Kathy) I-297 Zaunbrecher, Barbara S. I-282
Wegerich, Philipp II-290 Zhang, Xue I-484
Whitlock, Laura A. II-211 Zhou, Jia I-337
Wilińska, Monika I-405 Ziefle, Martina I-282, I-414, II-38, II-423
Wille, Matthias II-123 Zimmermann, Gottfried I-145, I-325, I-426,
Witte, Hartmut II-290 II-465

Zhou. J. (2015) - Human Aspects of IT For The Aged Population

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Jia Zhou · Gavriel Salvendy (Eds.

for the Aged Population

Design for Aging

ISSN 0302-9743 ISSN 1611-3349 (electronic)

Library of Congress Control Number: 2015942475

Springer Cham Heidelberg New York Dordrecht London

Printed on acid-free paper

Springer International Publishing AG Switzerland is part of Springer Science+Business Media

The 17th International Conference on Human-Computer Interaction, HCI International

May 2015 Constantine Stephanidis

Program Board Chairs: Gavriel Salvendy, USA & P.R. China,

• Jenay Beer, USA • Jean-Claude Marquie, France

The 18th International Conference on Human-Computer Interaction, HCI International

HCI Design and Evaluation Methods for the Elderly

The Benefits of Involving Older People in the Design Process . . . . . . . . . . . 3

Emotions Identification to Measure User Experience Using Brain Biometric

Adopting Scenario-Based Design to Increase the Acceptance of Technology

Constructing Third Age eHealth Consumers by Using Personas

Capturing Older People’s Cognitive Capability Data for Design . . . . . . . . . . 44

Designing Tangible Interactions for Aged Users Though Interactive

Developing a Framework for Effective Communication with Older People . . . 61

Music in the Retiring Life: A Review of Evaluation Methods

Time Reduction Design Method for Cognitive Assist Technology . . . . . . . . . 94

A Robot of My Own: Participatory Design of Socially Assistive Robots

Universal Design as an Approach to Technology Intervention for Seniors . . . 115

A Living Lab Method for Innovations to Increase Quality of Life

Talking Faces in Lab and Field Trials: A View on Evaluation Settings

Gamification and Accessibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

ICT Use and Acceptance

Evaluating All-Inclusive ICT with Developers, End Users

Patterns of ICT Use among “Senior Technology Experts”:

Why Age Is Not that Important? An Ageing Perspective on Computer

Values and Ethics in Making Emerging Technologies Work

Accessing InterACTion: Ageing with Technologies and the Place

Review of Empirical Research in Recent Decade About the Use of IT

Exploring the Impacts of Age and Usage Experience of e-Service

Acceptance of ICTs by Older Adults: A Review of Recent Studies . . . . . . . . 239

An Appraisal-Based Approach to the Stigma of Walker-Use. . . . . . . . . . . . . 250

Perceptions of Computer System Usefulness: Insights for Design

Pitfalls when Placing Electricity Pylons - The Influence

Aging, the Web and Social Media

Usability Evaluation of a Social Networking Site Prototype

ICT Access in Libraries for Elders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307

Examining the Validity of the Banner Recommendation System . . . . . . . . . . 317

Conducting Acceptance Tests for Elderly People on the Web:

Older Adults’ Usage of Web Pages: Investigating Effects of Information

Perceived Barriers for Older Adults’ Shopping Channel Selection Toward

Processing Speed and Vocabulary are Related to Older Adults’ Internet

Validation of the Computer Literacy Scale (CLS) . . . . . . . . . . . . . . . . . . . . 365

Age(ism) in Digital Information Provision: The Case of Online Public

A Framework for Evaluating the Implementers’ Experience in Making

The Study of Using Facebook in Taiwan’s Elderly Population—a Case

An Older Person and New Media in Public Discourses: Impossible

Technology Generation and Media Usage in B-2-B Communication:

Patterns for User Interface Adaptations: Towards Runtime Adaptations

The Elderly and Mobile Devices

Older People’s Attitude Towards Mobile Communication in Everyday Life:

Differences in the Adoption of Smartphones Between Middle Aged Adults

Ease-of-Use of Tactile Interaction for Novice Older Adults . . . . . . . . . . . . . 463