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PURPOSE In the digital society, people need to make use of a range of everyday technology (ET) when engaging in activities in various places outside home. The aim of this study was to describe and compare the use of ET and places visited outside the home and, also, to describe the relationship between them in people with different severity of disability after acquired brain injury (ABI). MATERIALS AND METHODS Instruments addressing ET use, places visited outside the home and severity of disability were used to assess 74 individuals with ABI. Relationships were analyzed statistically. RESULTS A significantly higher use of personal ET related to public space and public space ET, a higher ability to use ET and more places visited outside the home was found in those with good recovery (GR) compared to those with moderate disability/severe disability (MD/SD). The use of ET was significantly correlated with places visited in the total sample and in those with MD/SD, but for those with GR, no significant correlations were found. CONCLUSIONS To facilitate participation after ABI, the relationship between the use of ET and places visited outside the home needs to be assessed in rehabilitation.Implications for rehabilitationDigitalization has increased the need of everyday technology (ET) when visiting various places in society.The use of ET was positively significantly correlated with the total number of places visited outside the home in the sample of people with acquired brain injury (ABI).Those with severe or moderate disability after their ABI used significantly fewer ET and visited fewer places compared to those with good recovery.Evaluation of the use of ET and places visited outside the home is important in rehabilitation to support participation after ABI.

The role of Everyday Technology (ET) use is presented as subsidiary or neutral in policy for age- and dementia-friendly communities; and yet, research suggests that older people, especially those with dementia, experience increased challenges using ET in their everyday lives. Through the lens of micro-citizenship, the study aims to deepen the knowledge about how use of ET outside the home, including portable ETs, relates to participation in places visited within public space among people with dementia over time. Using a longitudinal study design, 35 people with dementia were recruited at baseline and followed over three years. Data were collected through semi-structured interviews using standardised questionnaires: the Participation in ACTivities and Places OUTside Home Questionnaire (ACT-OUT) and the Everyday Technology Use Questionnaire (ETUQ). Random intercept modelling and descriptive statistics were used to analyse the data. Throughout the three-year study, decreasing use of ET outside the home, including portable ETs, was associated with decreasing participation in places visited within public space, in a statistically significant way when controlling for age (F = 7.59, p = 0.01). The findings indicate that facilitating access and use of ET outside the home, among people with dementia, should be integral to promoting and maintaining participation in age- and dementia-friendly communities.

Introduction Older persons with cognitive impairment have often been disregarded in providing information on their own perceptions. This study explored the number of relevant everyday technologies and the ability to use everyday technologies as perceived by persons with cognitive impairment in comparison with their proxies’ estimates using the Short Everyday Technology Use Questionnaire. Method In this cross-sectional study, persons with cognitive impairment ( n = 21) and their proxies ( n = 21) were interviewed on separate occasions with the Short Everyday Technology Use Questionnaire, which measures the number of relevant everyday technologies and the ability to use everyday technologies. The data were analysed with t-tests, z-comparisons, and Fisher’s exact test. The level of significance was set at p Results At the group level, no significant differences were found between persons with cognitive impairments’ perceptions and their proxies’ estimates regarding the number of relevant everyday technologies or the ability to use everyday technologies. On the individual level, significant differences were found in the ability measures within four out of the 21 dyads. Conclusion The persons with cognitive impairment and their proxies verified each other’s responses, providing evidence that persons with cognitive impairment should be the primary source for information about their own everyday technology use.

Everyday information and communication technologies (EICTs) are increasingly being used in our society, for both general and health-related purposes. This study aims to compare how older adults with cognitive impairment perceive relevance and level of EICT challenge between eHealth use and general use.This cross-sectional study includes 32 participants (65-85 years of age) with cognitive impairment of different origins (due to e.g., stroke or dementia). The Short Everyday Technology Use Questionnaire+ (S-ETUQ+) was used, providing information about the relevance of EICTs and measuring the EICT level of challenge. Data were analysed with descriptive statistics, standardizedThe result shows that the perceived amount of relevant EICTs for eHealth use was lower in all 16 EICTs compared to those of general use. About the perceived level of challenge, a significant difference was detected in one of the seven included EICTs between eHealth use and general use.In this sample, all EICTs were perceived as having lower relevance for eHealth use compared to general use, suggesting that the purpose of using an EICT affects the perceived relevance of it. Also, once an EICT is perceived as relevant and used for eHealth purposes, there seem to be little to no differences in perceived challenge compared to the same EICT used for general purposes.Implications for rehabilitationAll stakeholders, including health care providers, need to be aware of the hindrances that come with digitalization, making it challenging to many citizens to make use of digital solutions.It is of great importance that social services including eHealth services be tailored to suit the individual/target group.Older adults may need support and an introduction to EICTs to discover the potential relevance of the specific device and/or service.

Background: Being engaged in activities in places outside the home after a stroke can be challenging. Knowledge about what characterize places outside the home is important to support participation.Objectives: To explore patterns of participation in places for activities outside the home after stroke and whether these patterns were associated with personal and environmental aspects.Material and methods: Sixty-three people with stroke were interviewed using the Participation in Activities and Places Outside Home (ACT-OUT) questionnaire. A two-step cluster analysis was used to identify patterns of participation and non-parametric test was used to explore potential associations to the patterns of participation.Results: Four clusters of patterns of participation, based on frequency, familiarity of the place/the way to the place and perceived distance, were identified. The patterns were significantly associated with type of place, activity domain, retained or abandoned participation, transportation and being accompanied by someone. The severity of disability was significantly associated with groups of individuals with different patterns of participation.Conclusions: Different combinations of aspects facilitated and hindered whether or not participation changed. To support people with stroke in their endeavour to retain or recapture participation, social support is important to consider in relation to transportation, activities and places outside the home.

Introduction Supporting older adults’ digital engagement requires an understanding of how occupational performance and technology use are related, as well as having a range of methods that can assist occupational therapists while observing occupational performance and management of technology. The study objectives were to investigate how older adults’ ability to perform digital technology-mediated occupations and ability to manage digital technology could be measured and to examine the association between these two abilities. Method Twenty-five older adults were observed performing digital technology-mediated occupations and managing digital technologies, and were scored on two instruments: the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. FACETS was used to generate respective multifaceted Rasch measurement models for scores on the instruments. The Spearman correlation test was used to investigate correlation between person ability measures from respective Rasch models of the instruments. Results The results include item, occupation, and technology difficulty estimates, as well as person ability measures that could illustrate older adults’ ability to perform occupations and to manage technology. There is also a strong positive correlation between these abilities. Conclusion Insight into an older person’s ability to manage technology can provide information about his or her ability to perform digital technology-mediated occupations and vice versa.

Background Daily functioning of people with cognitive disorders such as mild cognitive impairment (MCI) is usually depicted by retrospective questionnaires, which can be memory-biased and neglect fluctuations over time or contexts. Objective This study examines the feasibility and usability of applying the experience sampling method (ESM) in people with MCI to provide a detailed and dynamic picture of behavioral, emotional, and cognitive patterns in everyday life. Methods For 6 consecutive days, 21 people with MCI used an ESM app on their smartphones. At 8 semi-random timepoints per day, participants filled in momentary questionnaires on mood, activities, social context, and subjective cognitive complaints. Feasibility was determined through self-reports and observable human-technology interactions. Usability was demonstrated on an individual and group level. Results Of the 21 participants, 3 dropped out due to forgetting to carry their smartphones or forgetting the study instructions. In the remaining 18 individuals, the compliance rate was high, at 78.7%. Participants reported that momentary questions reflected their daily experiences well. Of the 18 participants, 13 (72%) experienced the increase in awareness of their own memory functions as pleasant or neutral. Conclusions Support was found for the general feasibility of smartphone-based experience sampling in people with MCI. However, many older adults with MCI are currently not in possession of smartphones, and study adherence seems challenging for a minority of individuals. Momentary data can increase the insights into daily patterns and may guide the person-tailored development of self-management strategies in clinical settings.

Social participation is a modifiable determinant for health and wellbeing among older people, however, social participation is increasingly dependent on technology use. This study investigated social participation in relation to Everyday Technology use and social deprivation of the living environment, among older people with and without dementia in the United Kingdom. Sixty-four people with dementia and sixty-four people without dementia were interviewed using standardized questionnaires: The Participation in ACTivities and Places OUTside Home Questionnaire and Everyday Technology Use Questionnaire. A mixed methods approach integrated statistical analyses and content analysis of free-text responses, through data visualizations. Small, statistically significant associations were found between social participation and Everyday Technology use outside home, for participants with dementia (Rs = 0.247, p = 0.049) and without dementia (Rs = 0.343, p = 0.006). A small, statistically significant association was identified between social participation and social deprivation in the living environment, among only participants with dementia (Rs = 0.267, p = 0.033). The content analysis and graphical joint display revealed motivators, considerations that require extra attention, and strategies for managing social participation. The results underline how Everyday Technology use can be assistive to social participation but also the need to consider social deprivation of the living environment, especially among people with dementia.

Background: As the use of everyday technology is increasingly important for participation in daily activities, more in-depth knowledge of everyday technology use in relation to diagnosis and gender is needed. The purpose of this study was to investigate the stability of the perceived challenge of a variety of everyday technologies across different samples of varying diagnoses including both males and females. Methods: This cross-sectional study used 643 data records from clinical and research samples, including persons with dementia or related disorders, acquired brain injury, intellectual disability, various mental or medical disorders, and adults without known diagnoses. The Everyday Technology Use Questionnaire, comprising 93 everyday technology artifacts and services (items) measuring the level of everyday technology challenge and relevance of and perceived ability to use these was used for data gathering. A two-faceted Rasch model in combination with differential item functioning (DIF) analyses were used for comparing item hierarchies across samples. Results: Only three items (3.2%) demonstrated a clinically relevant DIF by gender, and nine items (9.7%) by diagnosis. Discussion: The findings support a stable hierarchy of everyday technology challenge in home and community that can facilitate planning of an accessible and inclusive society from a technological departure point. Implications for Rehabilitation The ability to manage everyday technology is increasingly important for participation in everyday activities at home and in the community for people with and without disabilities. This study demonstrates that differences in perceived challenges in using various everyday technologies across gender and diagnosis are minimal. The findings provide evidence of no or minor systematic bias in testing when using the Everyday Technology Use Questionnaire in clinical practice and research. Empirical knowledge about the perceived challenge of specific everyday technologies of people with variations in gender or diagnosis is still sparse, hence this study can inspire practice and future research.

As context may impact everyday technology (ET) use it is relevant to study this within different contexts.To examine the usefulness of the Everyday Technology Use Questionnaire (ETUQ) in different contexts by investigating and comparing (1) the level of challenge of ETs in the ETUQ and (2) the relevance of and perceived ability to use ET in samples of Swedish and Japanese older adults.The Swedish and the Japanese samples (n = 86/86) were interviewed using the ETUQ about relevance of and perceived ability to use ET. Data were analyzed using Rasch analysis, chi square and a general linear model. Moreover, Differential Item Functioning (DIF) was investigated.The hierarchy of ETs' level of challenge was generally stable in the two contexts. On group-level, the relevance was somewhat higher and the perceived ability to use ET significantly higher in the Swedish sample than in the Japanese.The similarities and differences between the technological landscapes of Sweden and Japan could be detected by ETUQ, demonstrating its usefulness in both countries. The potential causes to the differences in relevance of and perceived ability to use ET between older adults in Sweden and Japan need further exploration.

Background: Everyday technologies (ET) such as smart phones, and internet banking are increasingly incorporated into daily activities. Therefore, valid assessments are needed to identify ability in ET use and to design and evaluate interventions. Aims: To evaluate and compare the stability over time (test-retest reliability) of measures generated with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) in older adults with cognitive impairment or mild dementia. Materials and Methods: Data was collected with S-ETUQ at two occasions (m = 20.9 days in between) in a sample of (n = 73) older adults with cognitive impairment of different origin (n = 38) or mild dementia (n = 35). Stability of each participant’s S-ETUQ measure was examined using standardised difference z-comparisons. The test-retest reliability coefficient of the S-ETUQ measures was determined by Intraclass Correlation Coefficients. Comparisons were performed using Mann-Whitney u-tests. Results: The S-ETUQ measures were statistically stable between the two occasions. Hence, the group of persons with cognitive impairment demonstrated slightly higher stability and fewer differences compared to the group with mild dementia. The ICCs (0.82–0.90) indicated good to excellent agreement. Conclusions: S- ETUQ can be used with older people with cognitive impairments of varying degree to gather reliable and precise information regarding their use of ET.

Background: The changing technological environment is reflected in regular updates made to the everyday technology (ET) use questionnaire (ETUQ). Newly added ETs may not present comparable challenges across countries and diagnoses. Aims: To identify whether country context, or dementia diagnosis, impact ETs’ challenge level. Material and methods: 315 older adults from three countries were included; Sweden (n = 73), United States (n = 114), England (n = 128), and had a confirmed diagnosis of mild dementia (n = 99) or no known cognitive impairment (n = 216). Differential Items Functioning (DIF) analysis was performed on 88 ETs included in the ETUQ by country and diagnosis. The impact of DIF was evaluated in a Differential Test Functioning (DTF) analysis. Results: Nine items (10.2%) in the ETUQ showed statistically significant DIF between countries; five of which were public space ETs and none of which were information and communication technologies (ICTs). Three ICT items, and no others, showed significant DIF by diagnosis. The items’ DIF was shown to have no impact upon person measures of ability to use ET in the DTF. Conclusions and significance: The utility of the ETUQ in occupational therapy practice and research internationally is highlighted through the stability of the challenge hierarchy and lack of impact on person measures.

Objective Self-monitoring is crucial to raise awareness for own behaviors and emotions, and thus facilitate self-management. The composition of self-monitoring within interventions, however, varies and guidelines are currently unavailable. This review aimed to provide a comprehensive overview of technology-based self-monitoring interventions that intend to improve health in middle-aged and older adults (>45 years). Methods Five online databases were systematically searched and articles were independently screened. A narrative synthesis of 26 studies with 21 unique interventions was conducted. Primary focus lay on the composition of self-monitoring within interventions, including technology used, health-aspects monitored, and type of feedback provided. Secondly, the usability of/adherence to the self-monitoring treatment, intervention effects, and their sustainability were examined. Findings Studies concentrated on middle-aged adults (mean of 51 years). Mobile technologies seem necessary to ensure flexible self-monitoring in everyday life. Social health aspects were rarely monitored. Mechanisms and the sustainability of intervention effect are understudied. Conclusion Digital self-monitoring technologies hold promise for future trials as they seem suitable to understand and support health-related self-management. Key elements including automatic and personal feedback following the blended care principle were highlighted and may guide study designs. Prospectively, research is especially needed to study sustained self-monitoring to support disease prevention and lasting lifestyle changes., Highlights • Digital self-monitoring interventions for middle-aged and older adults show great diversity. • Mobile technologies (e.g. smartphones) are needed for flexible self-monitoring. • Social health aspects (e.g. social networks/company) are rarely monitored. • Mechanisms and sustainability of intervention effects are understudied. • More research is needed on prevention and lasting lifestyle changes.

Occupational therapists support everyday technology use; however, it is necessary to consider the challenges that people with dementia encounter with everyday technologies when participating in various places within public space.The purpose of the study was to explore stability and change in participation in places visited within public space in relation to the relevance of everyday technologies used within public space.People with dementia (Both samples participated in places within public space; however, participation and relevance of everyday technologies were significantly lower for the dementia group.To enable participation, occupational therapists need to be aware of challenges that technologies and places within public space present to people with dementia.

Objectives: Everyday technologies (ETs) can be challenging to use, particularly for older adults with cognitive impairments. This study evaluated the relationship between the self-perceived ability to use ET and observable performance of self-chosen and familiar, but challenging ETs in people with mild cognitive impairment (MCI) or dementia.Method: A self-perceived report, the Everyday Technology Use Questionnaire (S-ETUQ), and a structured observational tool, the Management of Everyday Technology Assessment (META), assessing the perceived and observed ability to use ET, were used in 41 people with MCI and 38 people with dementia. Correlations were investigated with non-parametric statistical tests.Results: In the dementia group, self-perceived report and observational scores correlated on a significant medium level (R-s=0.44, p=0.006). In the MCI group, no significant correlation was found.Conclusion: The findings of this study suggest the ability of older adults with cognitive impairments to use ETs can be depicted with self-perceived reports as well as with observations. However, the combination of both approaches is recommended to get a comprehensive picture. While the S-ETUQ provides a broad picture of the use, presence and relevance of technologies in an individual's life, the META describes a specific human-technology interaction in detail. Furthermore, the results suggest people with early dementia retain the ability and insight to accurately reflect on their own ability to use ET, emphasizing the need to include their experiences in research and clinical work.

Introduction The number of older adults living with mild cognitive impairment (MCI) or mild-stage Alzheimer's disease (AD) is increasing and they are often expected to live in their own homes without support, despite limited ability to perform daily life activities. The Everyday Technology Use Questionnaire (ETUQ) has proven to be able to separate these groups and might also have potential to predict overall functional level (need of assistance in daily life activities) among them. Aim To investigate whether the ETUQ can predict overall functional level among older adults with MCI or mild-stage AD. Method Participants were older adults with a mean age of 76 years with MCI (n = 28) or mild-stage AD (n = 39). A three-step scale indicating (i) independence, (ii) need for minimal assistance or (iii) need for moderate to maximal assistance in daily life was dichotomised in two ways and used as outcome variables in two logistic regression models. Predictors in both models were perceived ability to use everyday technology (ET) and amount of relevant everyday technologies measured by the ETUQ. Ethical approval was obtained from the regional Ethical Committee. Result Perceived ability to use ET discriminated individuals who were independent or in need of minimal support from those in need of moderate to maximal assistance (OR = 1.82, p < 0.01, confidence interval = 95%; 1.76–2.82). The amount of relevant everyday technologies discriminated individuals who were independent from those in need of assistance at any level (OR = 1.39; p < 0.01; confidence interval = 95%; 1.11–1.75). Conclusion Both perceived ability to use ET and amount of relevant everyday technologies had potential to predict overall function but at different levels. The findings support the predictive validity of the ETUQ and suggest further research for the development of clinical cut-off criteria.

The Interdisciplinary Network for Dementia Using Current Technology, INDUCT, is a Marie Sklodowska Curie funded International Training Network that aims to develop a multi-disciplinary, inter-sectorial educational research framework for Europe to improve technology and care for people with dementia, and to provide the evidence to show how technology can improve the lives of people with dementia. Within INDUCT (2016-2020) 15 Early Stage Researchers worked on projects in the areas of Technology to support every day life; technology to promote meaningful activities; and health care technology.Three transversal objectives were adopted by INDUCT: 1) To determine the practical, cognitive and social factors needed to make technology more useable for people with dementia; 2) To evaluate the effectiveness of specific contemporary technology; and 3) To trace facilitators and barriers for implementation of technology in dementia care.The main recommendations resulting from the research projects are integrated in a web-based digital Best Practice Guidance on Human Interaction with Technology in Dementia which will be presented at the congress. The recommendations are meant to be helpful for different target groups, i.e. people with dementia, their formal and informal carers, policy makers, designers and researchers, who can easily select the for them relevant recommendations in the Best Practice Guidance by means of a selection tool. The main aim of the Best Practice Guidance is to improve the development, usage and implementation of technology for people with dementia in the three mentioned technology areas.This Best Practice Guidance is the result of the intensive collaborative partnership of INDUCT with academic and non-academic partners as well as the involvement of representatives of the different target groups throughout the INDUCT project.Acknowledgements: The research presented was carried out within the Marie Sklodowska Curie International Training Network (ITN) action, H2020-MSCA-ITN-2015, grant agreement number 676265.

Background/Objective The Everyday Technology Use Questionnaire (ETUQ), which evaluates the perceived relevance of and the perceived ability in everyday technology (ET) use, has demonstrated acceptable psychometric properties in Swedish studies of older adults. The aim of this study was to examine the reliability and validity of the ETUQ in a Japanese context in older Japanese adults. Methods A sample of older Japanese adults (n = 164) including persons with (n = 32) and without (n = 132) cognitive impairment was interviewed with the ETUQ, including original items (ETs) and added Japanese context-specific items. Data were analyzed using a Rasch measurement model. Results The analysis demonstrated acceptable functioning of the rating scale, internal scale validity, person response validity, and person-separation reliability of the Japanese ETUQ according to the Rasch model. However, evidence supporting unidimensionality in the Japanese ETUQ was not consistent in this sample. The added Japanese items did not significantly change the estimated individual person measures of perceived ability to use ET. Conclusion The Japanese ETUQ seems to be a sensitive tool to evaluate perceived ability in ET use among elderly people in Japan with and without cognitive impairment. Therefore, it could be used in research and clinical practice.

BACKGROUND: Everyday technology, ET (e.g. computers, TV’s and vending machines) perceived as relevant and used in everyday activities change continuously. Not being able to keep up with these changes may hinder participation in activities. OBJECTIVE: To investigate stability and change in perceived relevance of ET, and in levels of perceived ET difficulty across two different occasions in time and between two similar samples of older adults with and without cognitive impairment. METHODS: Data of perceived relevance and difficulty in ET use in the samples (n = 157/118), collected with the Everyday Technology Use Questionnaire (ETUQ) was investigated. RESULTS: Thirty-three (70%) of the ETs in the ETUQ significantly increased in relevance, while the perceived levels of difficulty were statistically similar in 40/47 ETs (85%) across the two time occasions. CONCLUSIONS: The perceived relevance of ET among older adults with and without cognitive impairment was indicated to increase over time, but the levels of perceived levels of difficulty of ETs did not change as much. This knowledge could be used to support and facilitate ET use in the aging population, and in general to influence society’s view of older people as active users of ET in activities at home and in public spaces.

Introduction In today's society, the access to and use of everyday technology, such as cell phones and internet-based services, can be claimed as a condition for participation in many tasks in everyday life. This study aims to determine and compare levels of perceived access to and difficulties in the use of common everyday technologies in public space, among people with acquired brain injury compared with controls. Methods The perceived access to and difficulty in the use of 14 everyday technologies were investigated in a sample with acquired brain injury ( n = 59; returned to work, n = 28; not returned to work, n = 31) and matched controls ( n = 52) using the everyday technology use questionnaire. Findings Perceived access to the everyday technologies was generally high. The potential to use each of the everyday technologies independently or with minor difficulties significantly differed between controls and persons with acquired brain injury in eight of the 14 everyday technologies. In particular, difficulties were found among those persons with acquired brain injury who had not returned to work. Conclusion People with acquired brain injury perceive that they have access to everyday technologies commonly used in public space, but the everyday technology difficulty is not always satisfactorily matched to their ability to use it. To enable participation in society, it is important to consider both the accessibility and usability of everyday technology.

Introduction: Knowledge is lacking of how technological development has affected occupational engagement and performance. Changes in the environment, for example, new technology, are likely to create changes in the dynamics of occupations and exploring this among older adults is especially important. This study aimed to explore what can drive and hinder the incorporation of everyday technology into occupations and how new technology affects occupational engagement and performance among older adults. Method: A constructivist grounded theory methodology was applied. Data were collected by individual interviews with six women and five men between the ages of 67 and 92 years old. Participants also varied as regards their cognitive function and living conditions. Results: The findings concerned the match between technology and the participants' perceptions of occupational purposes, needs of control and safety, and the kind of technology user they strived to be. A good match was a driving force for technology usage and satisfaction with the altered occupations and vice versa. Conclusion: Occupational engagement and performance in relation to technology use can be facilitated, which is useful knowledge for stakeholders developing and implementing new technology, as well as those who encounter older adults with the needs or desire to use technology in their daily occupations.

Background: In order to develop supporting interventions for people demonstrating problems ET use, a detailed level of description of strengths and deficits is needed. Aims: To explore clusters of specific performance skill required when using ET, and to evaluate if and in what way such clusters are associated with age, gender, diagnosis, and types of ETs managed. Materials and methods: A secondary analysis of 661 data records from 203 heterogeneous samples of participants using the Management of Everyday Technology Assessment (META) was used. Ward’s method and a hierarchical tree cluster analysis were used to determine and define the skill clusters. Results: Four distinct clusters of performance skill item profiles were found, across the 661 data records. These were then, based on each individuals’ cluster profiles in managing ET, categorized into two groups. The two groups were associated with, diagnosis and type of ETs managed. Conclusions and significance: The findings support a more dyadic person-ET approach in evaluation of ET management. The information from the skill clusters can be used to develop targeted intervention guides for occupational therapy and healthcare.

To evaluate the test-retest reliability of the Management of Everyday Technology Assessment (META) in a sample of people with acquired brain injury (ABI).The META was administered twice within a two-week period to 25 people with ABI. A Rasch measurement model was used to convert the META ordinal raw scores into equal-interval linear measures of each participant's ability to manage everyday technology (ET). Test-retest reliability of the stability of the person ability measures in the META was examined by a standardized difference Z-test and an intra-class correlations analysis (ICC 1).The results showed that the paired person ability measures generated from the META were stable over the test-retest period for 22 of the 25 subjects. The ICC 1 correlation was 0.63, which indicates good overall reliability.The META demonstrated acceptable test-retest reliability in a sample of people with ABI. The results illustrate the importance of using sufficiently challenging ETs (relative to a person's abilities) to generate stable META measurements over time. Implications for Rehabilitation The findings add evidence regarding the test-retest reliability of the person ability measures generated from the observation assessment META in a sample of people with ABI. The META might support professionals in the evaluation of interventions that are designed to improve clients' performance of activities including the ability to manage ET.

Objectives: E-health services are increasingly offered to provide clients with information and a link to healthcare services. The aim of this study is to investigate the perceived access to and the potential to use technologies important for e-health services among older adults with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD) and controls. Method: The perceived access to and perception of difficulty in the use of everyday technology (such as cell phones, coffee machines, computers) was investigated in a sample of older adults (n = 118) comprising three subsamples: adults with MCI (n = 37), with mild AD (n = 37), and controls (n = 44) using the Everyday Technology Use Questionnaire (ETUQ). The use of seven technologies important for e-health services was specifically examined for each subsample and compared between the subsamples. Results: The findings demonstrated that the older adults in all subsamples perceive access to e-health technologies and potentially would use them competently in several e-health services. However, among persons with AD a lower proportion of perceived access to the technology was described, as well as for persons with MCI. Conclusion: To make the benefits of e-health services available and used by all clients, it is important to consider access to the technology required in e-health services and also to support the clients’ capabilities to understand and use the technologies. Also, the potential use of the ETUQ to explore the perceived access to and competence in using e-health technologies is a vital issue in the use of e-health services.

BACKGROUND: Older adults may have difficulties in using everyday technologies, ET, e.g. micros, computers, particularly those with cognitive impairment. To guide supportive interventions, more knowledge of how to best assess ET use is needed. OBJECTIVE: To provide new knowledge of perceived and observed levels of difficulty of ETs in older adults with and without cognitive impairment. METHODS: Two samples of older adults (n = 118 and 116) with and without cognitive impairment were assessed. One was interviewed with the Everyday Technology Use Questionnaire (ETUQ) about perceived difficulties in ET use. The other sample’s observed ability to manage ET was assessed with the Management of Everyday Technology (META). Data was analyzed using a Rasch measurement model and rank-ordered hierarchies of perceived and observed levels of ET difficulty were identified, correlated and examined. RESULTS: Findings demonstrated a correlation of 0.63 ( p< 0.001). The upper range of both hierarchies contained more complex ETs like cell phones and computers while the lower comprised more home maintenance ETs. CONCLUSIONS: Perceived and observed levels of ET difficulty appear as similar, yet not identical constructs. In self-reports, though, ETUQ to a great extent seems to capture levels of ET difficulty. However, in clinical practice observations of actions may guide interventions, as they can identify why an ET is difficult.

Technology increasingly influences the everyday lives of most people, and the ability to manage technology can be seen as a prerequisite for participation in everyday occupations. However, knowledge of the ability and skills required for management of technology is sparse. This study aimed to validate a new observation-based assessment, the Management of Everyday Technology Assessment (META). The META has been developed to assess the ability to manage technology in everyday life. A sample of 116 older adults with and without cognitive impairment were observed and interviewed by the use of the META when managing their everyday technology at home. The results indicate that the META demonstrates acceptable person response validity and technology goodness-of-fit. Additionally, the META can separate individuals with higher ability from individuals with lower ability to manage everyday technology. The META can be seen as a complement to existing ADL assessment techniques and is planned to be used in both research and practice.

Introduction Knowledge of the conditions under which older adults facing cognitive decline engage in everyday activities is of major importance for occupational therapists in designing supportive interventions. This study aimed to investigate perceived activity involvement over time and its longitudinal relationship to perceived ability to use everyday technology in older adults with mild cognitive impairment. Method Thirty-seven older adults with mild cognitive impairment at inclusion were assessed over 4 years. Overall and item-specific activity involvement were analyzed using mixed-linear-effect modeling and differential item functioning. Furthermore, overall activity involvement and ability in everyday technology use were correlated. Results Overall activity involvement decreased significantly over time. When adjusting for declining ability in the sample, actual differential item functioning indicated descending involvement in seven of 15 activities, while eight activities were stable. All leisure activities descended. The positive correlations between activity involvement and ability in everyday technology use became stronger over time. Conclusion Variations across activities and time-points suggest that occupational therapists should repeatedly monitor the increasingly associated aspects of activity involvement and ability to use everyday technology in persons with cognitive decline.

Date Presented 3/31/2017 New empirical knowledge defines four distinct skill profiles among older people with and without cognitive limitations when using everyday technology, which supports targeted occupational therapy interventions to promote technology use in home and society that goes beyond a specific diagnosis. Primary Author and Speaker: Anders Kottorp Contributing Authors: Mandana Fallahpour, Camilla Malinowsky, Maria Larsson Lund, Louise Nygård

Everyday technology (ET), including computers and automated telephone services, is increasingly required for everyday functioning. However, people with acquired brain injury (ABI) may have difficulty with ET use. To design interventions to support ET use, further knowledge of how to assess dimensions of such use is needed.This study investigated the relationship between the perceived difficulty of ET use (self-reported using the short version of the Everyday Technology Use Questionnaire, S-ETUQ) and observed ability to use ET (observed using the Management of Everyday Technology Assessment, META) in a sample of people with ABI (n = 81). Data were analysed using a Rasch measurement model, and person measures of perceived difficulty and observed ability to use ET were identified and correlated. Results and conclusions. The person measures had a correlation of 0.49 (p0.001). In groups of different severity levels after ABI, significant associations were found in the moderate (0.36) and severe (0.47) disability groups. In the good recovery group, only a non-significant correlation was found (0.21). This indicates that the S-ETUQ and the META measure different but complementary dimensions of ET use. Hence, the assessments are proposed to be used together in clinical practice to more fully understand the ability of people with ABI to use ET.

Background: The use of everyday technology (ET) is important for many activities in daily life (ADL) and can be especially challenging for older adults with cognitive impairments. Objective: The aim was to explore associations between ADL performance and perceived ability to use ET among older adults with mild stage Alzheimer's disease (AD) and mild cognitive impairment (MCI). ADL motor and process ability, and ability to use ET were also compared between the groups. Methods: Participants with AD (n = 39) and MCI (n = 28) were included. Associations and group differences were explored with non-parametric statistics. Results: Significant correlations were found between ADL process ability and ET use in both groups (Rs = 0.44 and 0.32, p < 0.05), but for ADL motor ability and ET use, correlations were only found in the MCI group (Rs = 0.51, p < 0.01). The MCI group had significantly higher measures of ADL process ability (p < 0.001) and ET use (p < 0.05). Conclusion: ADL performance ability and perceived ability to use ET are important to consider in evaluations of older adults with cognitive impairments. Group differences indicate that measures of ADL performance ability and ET use are sensitive enough to discriminate the MCI group from the AD group with individually overlapping measures.

Erworben im Rahmen der Schweizer Nationallizenzen (http://www.nationallizenzen.ch), Background: The ability to manage everyday technology (ET), such as computers and microwave ovens, is increasingly required in the performance of everyday activities and participation in society. This study aimed to identify aspects that influence the ability to manage ET among older adults with and without cognitive impairment. Methods: Older adults with mild Alzheimer's disease and mild cognitive impairment and without known cognitive impairment were assessed as they managed their ET at home. Data were collected using the Management of Everyday Technology Assessment (META). Rasch-based measures of the person's ability to manage ET were analyzed. These measures were used as dependent variables in backward procedure ANOVA analyses. Different predefined aspects that could influence the ability to manage ET were used as independent variables. Results: Three aspects had a significant effect upon the ability to manage ET. These were: (1) variability in intrapersonal capacities (such as “the capacity to pay attention and focus”, (2) environmental characteristics (such as “the impact of the design”) and (3) diagnostic group. Conclusions: Variability in intrapersonal capacities seems to be of more importance than the actual level of intrapersonal capacity in relation to the ability to manage ET for this sample. This implies that investigations of ability to manage ET should also include intraperson variability. Additionally, adaptations in environmental characteristics could simplify the management of ET to support older adults as technology users.

Everyday technologies (ET) are an important part of the environment in which we live and interact, and older adults with cognitive impairments have to be able to manage ETs in order to participate in society. The aim of the present study was to bring new insight into what makes an ET easy or difficult to use for older adults with and without cognitive impairment. Older adults with and without cognitive impairments (n=116) were observed managing 27 ETs. In order to analyze and detect variables that influenced the level of difficulty of the ETs, a regression analysis was used and predefined assumptions were investigated. The results revealed that ETs that were used less than once a week were more difficult to handle, as were those with a complex design. The results suggest that ETs, more specifically Information and Communication Technology, need to be designed to be more user-friendly and less complex, and older adults that wish to continue using an ET need to be frequent users. The age and gender of the user, and how long the ET had been in use did not relate to how difficult an ET was to manage.

Purpose: The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or mild cognitive impairment (MCI) with older adults without known cognitive impairment (OA). Method: Persons with mild-stage dementia (n = 38), MCI (n = 33) and OA (n = 45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Assessment (META). A computer application of a Rasch measurement model was used to generate measures of participants' ability to manage technology. These measures were compared groupwise with ANCOVA. Results: The management of everyday technology was significantly more challenging for the samples with mild-stage Alzheimer's disease (AD) or MCI compared to the OA sample (AD - OA, p < 0.001; d = 1.87, MCI - OA, p < 0.001; d = 0.66). The sample with MCI demonstrated a significantly higher ability to manage technology than the sample with mild-stage AD (AD - MCI, p < 0.001; d = 1.23). However, there were overlaps between the groups and decreased ability appeared in all groups. Conclusion: Persons with cognitive impairment are likely to have decreased ability to manage everyday technology. Since their decreased ability can have disabling consequences, ability to manage technology is important to consider when assessing ability to perform everyday activities.