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Perceived risks, concession travel pass access and everyday technology use for out-of-home participation: cross-sectional interviews among older people in the UK.
Karolinska institutet; University College London, United Kingdom.ORCID iD: 0000-0001-5804-0433
Karolinska institutet.ORCID iD: 0000-0003-1813-7390
Karolinska institutet; Malmö universitet.ORCID iD: 0000-0002-8976-2612
University College London, United Kingdom; North East London NHS Foundation Trust, United Kingdom.ORCID iD: 0000-0002-5278-1756
Show others and affiliations
2020 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 20, no 1, article id 192Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The health-promoting qualities of participation as an opportunity for social and cognitive engagement are well known. Use of Everyday Technology such as Smartphones or ATMs, as enabling or disabling factors for out-of-home participation is however under-researched, particularly among older people with and without dementia. Out-of-home participation involves participation in places and activities outside of a person's home, in public space. Situated within the context of an increasingly technological society, the study investigated factors such as perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK.

METHODS: One hundred twenty-eight older people with and without dementia in urban and rural environments in the UK, were interviewed using the Participation in ACTivities and Places OUTside Home (ACT-OUT) Questionnaire and the Everyday Technology Use Questionnaire (ETUQ). Associations between Everyday Technology use, perceived risk of falling, functional impairment, access to a concession travel pass and out-of-home participation were investigated using ordinal regression.

RESULTS: A higher probability of Everyday Technology use (Odds Ratio [OR] = 1.492; 95% Confidence Interval [CI] = 1.041-1.127), perceived risk of falling outside home (OR = 2.499; 95% CI = 1.235-5.053) and, access to a concession travel pass (OR = 3.943; 95% CI = 1.970-7.893) were associated with a higher level of out-of-home participation. However, other types of risk (getting lost; feeling stressed or embarrassed) were not associated with out-of-home participation. Having a functional impairment was associated with a low probability of a higher level of out-of-home participation (OR = .470; 95% CI = .181-1.223). Across the sample, 'outside home' Everyday Technologies were used to a higher degree than 'portable' Everyday Technologies which can be used both in and outside home.

CONCLUSIONS: The study provides insights into perceived risks, access to a concession travel pass and use of Everyday Technologies, and their relationship with out-of-home participation, among older people in the UK. Increased knowledge about factors associated with out-of-home participation may help to guide targeted health and social care planning.

Place, publisher, year, edition, pages
2020. Vol. 20, no 1, article id 192
Keywords [en]
Activities of daily living, Dementia, Environment, Older adults, Risk, Social participation, Technology
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:esh:diva-8785DOI: 10.1186/s12877-020-01565-0PubMedID: 32503429OAI: oai:DiVA.org:esh-8785DiVA, id: diva2:1548230
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2013–2104
Note

Forskningsfinansiär:  Marie Skłodowska Curie Actions –Innovative Training Networks, H2020-MSCA-ITN-2015

Projektnummer: 676265

Available from: 2021-04-29 Created: 2021-04-29 Last updated: 2024-07-04Bibliographically approved
In thesis
1. The participation of older people with and without dementia in public space, through the lens of everyday technology use
Open this publication in new window or tab >>The participation of older people with and without dementia in public space, through the lens of everyday technology use
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Participation in activities and places within public space has been linked to numerous health benefits and yet, little is known about participation among older people with and without dementia. Insights about participation in activities and places within public space can contribute to the somewhat ambiguous definition of participation, as “involvement in a life situation”, by acknowledging the complexity and interrelatedness of subjective, social, contextual, temporal, and technological aspects of participation. Thus, the overarching aim of the four studies was to explore participation in activities and places within public space, among older people with and without dementia in two European countries (Sweden and UK), and to evaluate how different aspects, such as the relevance and perceived ability to use Everyday Technologies (ETs), interact with and influence participation, over time.

Across all studies, interviews used the Participation in Activities and Places Outside Home Questionnaire (ACT-OUT) and the Everyday Technology Use Questionnaire (ETUQ), in order to focus on the perspectives of older people with and without dementia themselves. Study one explored stability and changes in participation in places visited within public space in relation to the relevance of ETs used in public space, among a baseline Swedish sample. Study two utilised ordinal regression to investigate the ways in which perceived risks and ET use were associated with out-of-home participation, among a UK sample of older people. Using a mixed methods design and data visualisations, study three delved into aspects of social participation in more depth, including ET use and social deprivation of the living environment, among two UK sub-samples of older people with and without dementia. Study four’s longitudinal design and multilevel modelling deepened the knowledge about how use of ET outside home, relates to participation in places visited within public space among a Swedish sample of older people with dementia over time.

Study one’s findings demonstrated a statistically significant positive association between a higher person measure of ability to use ETs and higher participation in places visited within public space, among the Swedish sub-sample of older people with dementia but not those without dementia. According to the ordinal regression model in study two, a higher probability of ET use was associated with a higher level of out-of-home participation, among the UK sample of older people. By elucidating motivators, considerations that require extra attention, and management strategies among UK sub-samples of older people with and without dementia, study three provided insights into the nuances of social participation. Finally, study four’s findings revealed that decreasing use of ET outside home was associated with decreasing participation in places visited within public space, in a statistically significant way when accounting for age.

In summary, this thesis contributes empirical insights about the participation of older people with and without dementia in activities and places within public space, through the lens of ET use. Such knowledge can be used to develop targeted health and social care planning and the design of more inclusive places, technologies, and services.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2020. p. 118
National Category
Occupational Therapy
Identifiers
urn:nbn:se:esh:diva-8823 (URN)9789180160841 (ISBN)
Public defence
2021-01-22, Rum H3, Zanderska Huset, Karolinska institutet, Alfred Nobels Allé 23, Huddinge, 09:00 (English)
Opponent
Supervisors
Available from: 2021-05-11 Created: 2021-05-11 Last updated: 2021-05-11Bibliographically approved

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