Abstracts Track 2024

Area 1 - Aging Well – Social and Human Sciences Perspective
Area 2 - Digital Health and e-health

Area 1 - Aging Well – Social and Human Sciences Perspective

Nr: 37
Title:

The Use of Internet is Associated with Social Isolation, but not with Depressive Symptoms Among Older Adults Who Are Primary Care Users in Chile
Authors:

Ximena Moreno and Natalia Cornejo
Abstract: Background: Depression is the most common mental health disorder at all ages, and it is associated with morbidity and mortality among older adults. Previous findings about the protective role of Information and Communication Technologies (ICT) use among older adults are not consistent, but they suggest a lower likelihood of depression among ICT users, depending on sociodemographic characteristics and health status, and on reason for using it. Also, it is possible that the use of ICT moderates the effect of protective or risk factors for depression among this age group. We hypothesized that the use of ICT would be associated with social support among older adults who are primary care users in Santiago, Chile, and that both factors would be negatively associated with depressive symptoms. Methods: We considered data of 228 older adults recruited to an ongoing study about barriers and facilitators for diagnosis and treatment of depression among older adults in Santiago, Chile. Participants are primary care users, aged 65 or more years, living in areas of middle and middle low socioeconomic status. Depressive symptoms were measured with the 9-item Patient Health Questionnaire. Social support was measured with the 6-item Lubben Social Network Scale. Daily or almost daily use of mobile messaging app or internet was self-reported. We described the frequency and factors associated with ICT use. We also explored the association between the use of ICT and social support. Finally, we analyzed the association of ICT use and social support with depressive symptoms, in univariate and multivariate logistic regression models. Results: The prevalence of depressive symptoms was 15.45%. Two thirds of participants used mobile messaging app (75.44%), and more than half used internet (55.70%). Both types of ICT were more frequent among people aged less than 75 years, and with complete secondary education or more. Internet use was associated with social support (p=0.004). The use of ICT was not associated with depressive symptoms. People at risk of social isolation were more than twice as likely to have depressive symptoms (p=0.012), but in the adjusted model, only disability and self-rated health were independently associated with the outcome. Conclusions: Consistent with other national reports, the use of ICT among older adults increased after the Covid-19 pandemics. With respect to our hypothesis, although internet use was associated with social support, and depressive symptoms were more frequent among people at risk of social isolation, the distribution of depressive symptoms was independent of the use of ICT. Nevertheless, it is important to further analyze the potential of ICT use to improve mental health among older adults who are primary care users in Chile. Aspects such as intergenerational support in the adoption and use of ICT, and the impact of access to internet based mental health interventions should be assessed.
Nr: 45
Title:

Development of a Massive Open Online Course to Caregivers During the Covid-19 Pandemic
Authors:

Maria José Lumini, Maria Rui Sousa, Berta Salazar and Teresa Martins
Abstract: Background: The COVID-19 disease caused several challenges to health systems, namely an increase in morbidity and mortality. The elderly are more vulnerable to this disease and more susceptible to develop serious complications. The WHO, recommends healthy directives to the elderly and their caregivers in the pandemic context. The Massive Open Online Courses (MOOC) emerge as a solution to support the empowerment of family caregivers of vulnerable people, especially in times of social isolation. Objectives: the study sought to develop and validate a MOOC, integrating personal and housing hygiene measures to be adopted in self-care related activities, surveillance and monitoring by caregivers of the most vulnerable home-dwelling dependent people, in order to provide safe care and prevent coronavirus infection. Methods: A methodological study was developed with two phases. Phase 1 aimed to validate the contents to be integrated into the MOOC and its development. Phase 2, a pilot study was carried out with a convenience sample of 33 caregivers to verify the adequacy of the course to its target audience, involved a group of caregivers. Caregivers filled one questionnaire to assess the gathered knowledge, the Family Caregiving Factors Inventory, one sociodemographic questionnaire and the questionnaire to evaluate the acceptance of the MOOC. Results: Participants presented an average knowledge score before attending the MOOC of 14.94 (SD=2.72) and after viewing the course of 16.52. The questionnaire to evaluate the acceptance of the MOOC, following the TAM model, shows that the caregivers were satisfied with the course, considering it useful, with clear and understandable information. Through the FCFI the vast majority of caregivers showed adequate knowledge to respond to the care challenges and good personal and social resources to accompany their family members. Conclusions: This MOOC constitutes an important tool to raise awareness and provide better training to informal caregivers.
Nr: 60
Title:

The Challenges into Recruiting Older Adults onto a Health-Related Technological Study: An Exploration of Barriers and Solutions
Authors:

Victoria L. Hall
Abstract: The purpose of this paper is to reflect on the challenges faced by researchers who were attempting to recruit older adults on a study which used digital technology to promote independence in their own homes by monitoring behaviour. A reflective account was taken from gatekeepers, older adults , carers and members of the recruiting team to gain an in-depth understanding of why recruitment issues occurred for the planned project. Five themes identified included 1) the perception of digital monitoring behaviour 2) research mistrust 3) friends family and carers perception of the study 4) researching in the context of COVID-19 and 5) Cultural considerations. Previous academic discourse focuses on recruiting older adults onto clinical trials and this paper adds to the understanding of recruiting older adults onto applied health/social science research. The paper provides an in depth understanding in recruiting older adults for a research project that used digital technology, and make some recommendations that could inform researchers and health and social care providers.

Area 2 - Digital Health and e-health

Nr: 39
Title:

Codevelopment of a Decision-Support Tool to Identify Suitable Digital Health Solutions for People Living with Neurocognitive Disorders: Study Protocol
Authors:

Marie-Pierre Gagnon, Anik Giguère, Maxime Sasseville, Holly Witteman, Samira Abbasgholizadeh Rahimi, Samira Amil, Roberta de Carvalho Corôa, Ellen Gorus and Ronald Buyl
Abstract: Background: Numerous technology applications are being developed to support independent living for older people with neurocognitive disorders. However, community-dwelling older people with mild to moderate cognitive impairment generally do not benefit from these technologies, as they find it difficult to identify and select those best suited to their needs and preferences. For people living with severe cognitive impairment, their informal caregivers and healthcare providers often lack information about existing technologies, or any indication of their suitability to support them. Objective: We aim to codevelop a decision-support tool that can be used by older people with mild cognitive impairment, family caregivers and healthcare providers. We will assess the usability and acceptability of the tool. Methods: We will use the framework proposed by Witteman et al. for co-developing decision-support tools. This framework includes three stages of iterative development cycles: 1) understanding users' needs and context; 2) developing and refining the prototype; and 3) observing users interacting with the prototype. We will follow the experience-centered codesign approach, based on collaboration between service users, service providers and researchers, to develop solutions to make services more relevant and adapted to users' realities. We will hold a half-day codesign workshop bringing together older people with mild cognitive impairment, informal caregivers, and healthcare providers. We will then use the online platform PADA to develop the prototype of the decision-support tool that would be validated among potential users. Implications: This project will provide a decision-support tool aimed at service users, informal caregivers, and healthcare providers to inform decisions regarding digital health technologies for independent living.
Nr: 40
Title:

Implementation of Behavioural Science Techniques to Facilitate Behaviour Change and Healthy Habit Formation in Individuals
Authors:

Si Yee Chan, Charmaine Ruling Lim and Pijika Watcharapichat
Abstract: The Growing Threat of Noncommunicable Diseases Noncommunicable diseases (NCDs) such as cancer, heart disease, and diabetes are the leading cause of death worldwide (CDC, 2023). Preventive medicine, which includes adopting healthy lifestyles, is an effective method to control NCDs, but obstacles such as lack of awareness and reluctance to change can hinder efforts. The Synergy of Digitalization and Behavioural Sciences in Preventive Medicine With digitalisation, healthcare has become more personalised, allowing for scalability to larger populations. Meanwhile, behavioural science research delves into the motivations behind individual and population-level health behaviours, enabling creation of policies, programmes, and products/services that promote better health for all (WHO, 2023). We leveraged validated behavioural science approaches to manage lifestyles and mitigate risk of chronic disease. By using a digital healthcare approach, we can personalise our solutions and scale them up for large populations. Designing a User Journey informed by Behavioural Science to instil healthy habits While making lifestyle changes can be exhilarating, it can also be a daunting task to many. We leverage upon best available evidence on habit formation to support users in initiating and maintaining healthy lifestyle changes. We devised a comprehensive 21-day user journey that considers varying levels of motivation which users exhibit during lifestyle change. The journey comprises seven key time points, namely day 0, 1, 3, 7, 14, 19, and 21. To ensure timely and effective interventions, we integrated appropriate behavioural change techniques (Michie et al., 2013) to support users at every stage of their journey. On the first day, we acknowledge that individuals may have differing levels of readiness when it comes to engaging in lifestyle change. As a solution, we embedded three behavioural change techniques: the readiness ruler, implementation intention, and provision of material incentives. These techniques work together to provide more autonomy to individuals with lower readiness, encourage the setting of intention and outcome goals, and create anticipation on expected rewards at the end of their journey. As users progress through their journey, their motivation may wane due to competing demands. To address this, at day 7, we introduce relevant educational materials that explain the non-linear nature of change. We assist users in re-attributing their challenges to external factors and connect them with other users who are working on similar habits for social support. As the user approaches the end of their journey, we highlight the saliency of consequences through strategically placed animations that simulates a countdown to their finish line, helping them anticipate successfully completing their journey. All behavioural change techniques were carefully selected to avoid any potential conflicting mechanisms of action. Conclusion In summary, our approach considers users’ varying motivation levels throughout their journey towards a healthier lifestyle. Behavioural change techniques are embedded strategically in an affordable and accessible digital platform that is scalable, yet personalized to each individual, ensuring end-to-end support and highest chance of success. With this, it has excellent potential as an effective and powerful tool to address the global rise of NCDs by promoting healthier communities and reducing risk of disease.
Nr: 46
Title:

Development of a Module for Promoting Physical Exercise in Caregivers of Dependent Individuals for a Web Platform
Authors:

Teresa Martins, Maria Rui Sousa, Maria José Lumini, Carla Cardoso, Daniela França and Fátima Araújo
Abstract: Background: The web platform designated as Caring for Dependent Individuals (INTENT CARE) provides specific information to family caregivers of dependent individuals and complements the guidance provided by nurses, promoting their autonomy and decision-making. It contains various modules (e.g., positioning, transfers, hygiene, nutrition, management of medication regimen) related to caring for the dependent person, facilitating the caregiver's role. This ongoing development work describes the stages of developing a module to be integrated into the INTENT CARE tool (http://pope.esenf.pt/intentcare/) to promote physical exercise and well-being among family caregivers. Method: In order to develop the contents to be integrated, a systematic literature review was first conducted to analyze the types of physical exercise and muscle relaxation programs available and their effectiveness in preventing caregiver burden and enhancing well-being. Based on this review, a program was designed, which will be submitted for review by a panel of experts consisting of healthcare and sports professionals to ensure that it meets technical and scientific validity and is adapted to the target population. The program development will follow the Plain Language methodology (Rude, 2012) and will be recorded on video. The video will have the duration of the exercise session with views from the frontal, lateral, and posterior planes (if applicable). Results: The results of the systematic literature review revealed a variety of programs including aerobic, strength, and muscle relaxation exercises, implemented by different professionals and in different settings (individuals' homes, gym, virtual environment). The programs varied in typology, duration, and structure but converged in evaluating their positive effects on caregivers' physical and psychological well-being and reducing burden. Conclusion: Scientific evidence demonstrates the benefits of physical exercise and muscle relaxation programs in promoting the health and well-being of family caregivers. These caregivers typically have limited time available, making solutions that can promote their well-being highly valuable.
Nr: 42
Title:

Enhancing Nursing Education Through Digital Scenario Tools
Authors:

Carla Fernandes, Teresa Martins, Francisco Santos, Maria José Lumini, Maria Rui Sousa, Maria José Peixoto, Rosa Freire, Berta Salazar and Fátima Araújo
Abstract: Background: Clinical simulation is widely acknowledged as an effective educational strategy for nursing students to acquire essential skills in a controlled environment. This study aimed to assess the pedagogical impact of a digital scenario-based tool compared to traditional paper-based scenarios in realistic simulation activities. Method: a within-subjects experiment was conducted with 128 second-year nursing students in Portugal. Two simulation activities were performed, one using traditional paper-based scenarios and the other utilizing scenarios created with the digital tool (https://scenario-tool-en.web.app). Following each simulation, students completed a questionnaire comprising 27 items assessing self-perceived pedagogical outcomes, including understanding clinical data, the influence of data on simulation performance, critical thinking in intervention planning, and recognition of the learning process. Data analysis encompassed descriptive statistics and paired t-tests to compare differences between simulations. Results: of the 128 participants, 103 completed the questionnaire, revealing higher scores in all items for the new scenario. Item analysis indicated significant mean differences, suggesting improved performance with the digital scenario-based tool. The new scenario was recognized for its contributions to learning, especially in understanding data and intended interventions. Conclusion: This study underscores the significance of realistic simulation in nursing education and the advantages of integrating digital technologies. The digital scenario-based tool not only enhances learning outcomes but also aligns with pedagogical guidelines. This approach offers a standardized process for scenario creation, streamlining processes, and providing learning experiences with enhanced fidelity. These findings have implications for adaptation to various educational contexts.