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Receive reminders for taking medication: The elderly had a user profile where they or their caregivers could set reminders for taking medication Figure 2 a , and the reminder message would appear in the television to the older adults while they were watching television see Figure 2 b. It is important to mention, that the objective of this study was not examine medication adherence among elders.

We aimed to assess the technology adoption of the proposed system to help elderly to have a better control of their daily activities. Therefore, at this stage of the project, factors such as errors in the dose of the drug or the incorrect selection of the medication were not considered.

Manage their agenda with their doctors: seniors or their caregivers were able to schedule medical appointments Figure 3 a ; the application showed notifications for these while they were watching television, so that they remembered their medical appointments see Figure 3 b. The agenda messages stayed on screen until the user took action with it. The information included in the detailed screen for the notification are:. This control panel allowed the caregivers more in-depth control of the information related to the data entered in iTVCare. From the initial interview, we characterized our users.

The TAM questionnaire was composed of 15 items grouped into four dimensions: perceived ease of use, perceived usefulness, attitude towards the utilization of the software, and intention to use.

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For each item, the answer used a Likert-type scale [ 29 ]. The measurement items employed in this study were constructed from previous literature studies [ 28 , 30 , 31 , 32 , 33 , 34 , 35 ]. Table 1 presents a descriptive analysis of dimensions and their details, such as the maximum possible value and the expected notional value, which is supposed to have a high probability of acceptance.

The values of the sub-scales were calculated using the sum of the maximum value possible for each item 7 on the Likert scale in the subscale. Table A1 presents the TAM questionnaire used in our study [ 28 , 30 ]. Furthermore, an analysis of descriptive statistics is summarized in Table 2 , where little variability in the responses was identified.

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In addition, Figure 5 shows the frequency distribution of TAM score. As observed in the four dimensions, the mean with standard deviation did not differ from the expected values shown in Table 1. This means that the averages were not far away from the proposed expected values. Therefore, in this way we could corroborate that the results were statistically similar to the expected results. Table 3 shows the results of the statistical test, in which it was found that most users of the developed iTV platform found it easy to use and useful.

Also, there was a positive attitude towards it, which could have caused greater willingness to use it. There were significant differences between the means of the four dimensions. For this purpose, we performed a Chi-squared test, where the null hypothesis was that the averages of the four dimensions were equal, while the alternative hypothesis was that at least one of the dimensions was different.

In addition, for each of the dimensions of the TAM instrument, we obtained valuable information about the opinions of our potential users. As final step, we inquired with the older adults about their general perception of iTVCare by applying a short interview with three questions:. The data collected from these interviews supported and complemented the findings obtained in the TAM questionnaire.

This study confirmed that older adults showed a strong intention of use towards a television-based platform to provide wellbeing. Some design concepts and products are intended to improve healthy ageing for seniors, and the literature discusses different approaches, mostly based on mobile phone applications. A major contribution of this study was to validate the viability of the use of a TV set and applications specially designed for TV to support an ageing-friendly environment.

Our results were in concordance with previous literature, such as the AAL FoSSIBLE project supporting social interactions through the development of smart TV applications to prevent isolation for older people living alone [ 36 ]. To meet the demand for these type of applications, the next generation of televisions must be prepared to offer interactive services and content to specific groups of users, according their characteristics and preferences [ 37 ]. However, a deeper understanding of which services may be of interest to older adults is required. Our experience in designing technology for elders indicated that this process can be very challenging; for this reason, it is very important to conduct technology acceptance studies to confirm the elderly perception of the usefulness of a technology, and to avoid the natural tendency to prefer staying with traditional ways instead of adopting technology.

Unfortunately, in previous works reported in the literature, technology adoption was not the core of their objectives and, therefore, not discussed in depth. There are some studies that have evaluated the acceptance of TV-based platforms for older adults, such as Rivas Costa et al. They also confirmed that a TV-based system has a high acceptability by older adults.

The objective of this project was not to validate the clinical results of the medicine intakes of seniors. That would require a pilot test with wider parameters. In this work, we only assessed the technology adoption of a TV-based system with a set of applications to help the elderly to have a better control of their daily activities. Although participating users were a representative sample of the State of Colima population, which at the same time is comparable to the Mexican population in middle size cities, a larger user sample would be needed to obtain significant results for an international profile.


As a general direction, we believe that designs aimed at older adults should continue to emphasize the simplification of interfaces, and make error recovery a main feature, clarifying errors with the simplest language, and explaining the process to resolve the situation. The highly positive acceptance of iTVCare was a good starting point, but a most robust platform is required to cover the main areas where ICT are used to improve the quality of life of the elderly at home or in nursing homes. The research related to the provision of care services to elderly people can be divided into two types [ 39 ]: a health care, and b social care.

We are planning to follow type a , since we previously explored the type b [ 13 ]. With the current instantiation of our platform, we will develop new applications to configure a core set to demonstrate the viability of our proposal.

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Some planned applications are: monitoring vital signs, remote consultation, exercise at home, entertainment, serious games, and those currently in use. The application of reminders for taking medication requires updating, since during the process, some issues arose relating to medication specific particularities, for example situations where older adults did not take a medicine; when they would need different doses over the day, or reminders to take medication when they are not at home.

We will review existing mechanisms and digital tools reported in the literature to support medication intakes for elderly people, and take into account important issues like intentional non-adherence, medication refill, tracking of dose skipping, or the accidental intake of another medication. After the update, the system will be deployed at the homes of elderly users or nursing homes, and access will be granted to their caregivers and relatives. We presented an electronic platform based on interactive television that helps Mexican seniors to have better control of their daily activities, such as medicine intake and medical appointments, and thus support them in achieving a better quality of life by not forgetting to take their medications and attend appointments with their doctors.

This information is presented through the television that they have in their homes and use daily in an age-friendly environment. As part of the design, an evaluation of technology acceptance by the elderly was carried out and we found that most users agreed that the tool was easy to use and had good usefulness. Users had a good attitude for using it, generating a strong intention to use this platform to support their daily life activities. The aim of this study was to obtain evidence whether or not the proposed technology would be accepted by older adults, and at the same time get a response to the question if television would be a really suitable platform for technology adoption by older people and, thus, it may help to overcome the digital gap they suffer [ 38 ].

This study confirmed that older adults positively accepted iTVCare. The authors would like to thank the nursing homes for the authorization to perform experiments in their facilities, and all of the persons that participated as subjects during the study. We acknowledge the comments and feedback received by two anonymous reviewers, we are grateful to professors Juan Contreras and Osval Montesinos for providing suggestions to improve the paper. This work was a collaborative effort between both authors. Pedro C. Luis E. National Center for Biotechnology Information , U.

Published online Jun 8. Jean Woo, Academic Editor. Author information Article notes Copyright and License information Disclaimer. Received Mar 3; Accepted Jun 3. This article has been cited by other articles in PMC. Abstract In Mexico, many seniors are alone for most of the day or live in public nursing homes.

Keywords: interactive television, seniors, elderly, homecare, technology adoption, public nursing homes. Introduction 1. Background Technological advancementsin information and communication technologies ICT play a fundamental role in all knowledge and service areas, but especially in health care, with the emergence of highly complex devices for home healthcare which helps service providers to communicate in-home with their patients [ 1 ]. Seniors and Interactive TV Simple interaction with computer systems is required for older people [ 12 ]. Several studies [ 15 , 16 ] demonstrate that: Seniors are a broad group with a high level of TV program consumption but little or no access to the information society.

As the TV is a natural device for these groups of people, the learning gap for TV applications is reduced, and in the future, it will be possible to provide other services together with homecare, such as: Preventive medicine. Dietary treatments cholesterol, diabetes, cardiovascular problems.

Formative programming content with interaction from the elders. Electronic payments useful for the groups that are not used to the Internet.

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Serious gaming to support cognition. Methods 2. Usage Context and Requirements The context usage for the developed platform was Colima, a state located in Mexico. As usability specialists, [ 21 ] compared younger and older participants and they found that older ones tended to: Take longer to learn new applications or devices. Take longer to complete tasks. Use different search strategies.

Perform worse on tasks relying on memory. Be more distractible. Have a harder time dealing with errors. Make more erratic or accidental movements with the pointer. Make more input errors. Have more trouble hitting on-screen targets. Design and Requirements The special needs of older people make it necessary to comply with design guidelines created to support their specific needs.

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Next we summarize the more relevant features: Minimize the number of steps: As the Human-TV Interaction system is mainly operational through a remote control and can be exasperating, we minimized the number of steps from the home screen to reach a given screen. Additionally, we used several recommendations that are quite well known and accepted: Use a very large font type; Use an easy to read font family; Use mixed case; Leave plenty of space; Present few calls to action; Design error messages to be clear; Make it easy to correct input errors; Avoid the use of scroll; Use high contrast between elements of the user interface.

The main components of the system architecture Figure 1 are described below: iTVCare: This layer represents the home system of the user, where the Google TV is installed. Services: The services layer includes the components to be consumed by iTVCare. Medical appointments: This component manages appointments with doctors.

Open in a separate window. Figure 1. Evaluation An assessment of technology adoption and user experience of the system was performed. Participants and Recruitment The assessment of technology acceptance was performed through a pilot test with a group of 50 seniors in the State of Colima.