Date Presented 4/8/2016

This project contributes important knowledge about the use of information and communication technologies (ICT) among older adults at risk for stroke. This information is important both because of the risks and possibilities of ICT in health care and to develop future practice innovations for occupational therapy.

Primary Author and Speaker: Eric Asaba

Contributing Authors: Eric Asaba, Ann-Helen Patomells, Susanne Guidetti, Anders Kottorp, Kerstin Tham

PURPOSE: The aim of this paper is to explore technology use and reported difficulties among older adults at risk for stroke with an emphasis on e-health applications.

BACKGROUND: Stroke is the third leading cause of global disease burden estimated using disability-adjusted life years and often leads to decreased functioning in everyday life due to impairments, activity limitations, and participation restrictions. Lifestyle-oriented interventions have been demonstrated to be cost effective and positive for health among older adults. Specific studies exploring how these ideas can be understood together with information and communication technologies (ICT) for persons at risk for stroke are yet scarce.

The growing emphasis on access to information, self-evaluation, and self-management using ICT such as Internet and mobile devices makes this area of research important for occupational therapy today. Even though 6 of 10 persons between ages 16 and 74 yr in Sweden, and more in the United States, have used the Internet on a smartphone/mobile phone, access to the specific ICT does not translate to competence in technology use. Because e-health services are increasingly used, it is important to empirically investigate the potential for e-health in relation to occupational therapy.

DESIGN: Qualitative and quantitative techniques are utilized in data gathering and analysis.

PARTICIPANTS: Purposive recruitment was used (N = 30) with inclusion criteria: ≥60 yr, physician-assessed hypertension and/or arrhythmias, and at least two other stroke risk factors.

METHOD: Everyday Technology Use Questionnaire (ETUQ) takes 30 min to administer and contains 90 items and was used to evaluate self-reported difficulty in everyday technology use (e.g., mobile phones, tablets, computers). Second, each ETUQ interview was followed with an open-ended interview/observation where participants were asked to elaborate on engaging occupations and the use of technologies.

ANALYSIS: Data from ETUQ will be analyzed using modern test theory (Rasch models), which is useful for evaluation of psychometric properties in more functional-based assessments. The ETUQ measures will in combination with person-, risk factor, and socioenvironmental–demographic variables be further analyzed using descriptive and hypothesis-testing statistics. Data gathered using open-ended interviews and observations will be analyzed using nonparadigmatic qualitative methods grounded in a narrative approach.

RESULTS: Ongoing, preliminary findings suggest that conditions for implementing e-health applications in stroke prevention within Swedish primary care contexts are good. The design of e-health screening and interventions require active involvement by future users. Engaging occupations can be an important nonpharmacological complement to current practice.

IMPACT: This project contributes important knowledge about the use of ICT among older adults at risk for stroke; the project will contribute to future ICT-supported solutions in assessment and intervention targeting primary and secondary prevention of stroke where occupational therapy can be central.