e-Health for Healthy Aging: Putting the Evidence into Practice

Marie-Pierre Gagnon

, Ronald Buyl

, Anik Giguère

, Sophie Éthier

, Kathleen Lechasseur

and Anne Bourbonnais

Faculty of Nursing Sciences, Université Laval, Québec, 1050 avenue de la Medecine, Quebec, Canada

Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, Jette, Belgium

Faculty of Medicine, Université Laval, Québec, 1050 avenue de la Medecine, Quebec, Canada

School of Social Work, Faculty of Social Sciences, Université Laval, Québec,

1030 avenue des Sciences-Humaines, Quebec, Canada

Faculty of Nursing, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, Quebec, Canada

Keywords: eHealth, Healthy Aging, Scientific Evidence, Knowledge Translation.

Abstract: Population aging represents a major challenge as the proportion of people aged over 65 years worldwide is

expected to reach 2 billion by 2050. This has profound implications for the planning and delivery of health

and social care. The knowledge we want to disseminate come from a systematic review on e-health

interventions for healthy aging (HA). This project arises from a research collaboration putting together

complementary expertise in information and communication technology and aging. The overarching goal of

this project is to ensure rapid translation of scientific evidence on effective e-health interventions promoting

HA in order to accelerate their implementation for the benefit of older adults and their caregivers. Various

knowledge translation strategies will be developed and implemented with knowledge users.

1 INTRODUCTION

Progresses in healthcare and major improvements in

living conditions have led to an important increase

of life expectancy in developed countries.

Worldwide, the proportion of people over 65 years

old is expected to grow from 10% to 22% by 2050

(World Economic Forum, 2016). More people are

living longer and want to stay active and healthy in

order to fully participate in life (Jin et al., 2015).

However, population aging also put pressure on

public health systems given the rise in the

prevalence of chronic diseases. According to

different forecasts, the future costs of population

aging could represent an increase between 2.5% and

7.6% of the Gross Domestic Product (GPD) by 2060

(de la Maisonneuve and Martins, 2013, Townsend,

2016). This challenges the sustainability of

healthcare and social services delivery (Illario et al.,

2015). It is thus important to explore solutions that

could optimize the use of resources for older adults

on the healthcare system.

Healthy aging (HA) encompasses the physical,

social, mental and spiritual dimension of health, and

promotes that older people take an active part in the

society without discrimination (Swedish national

Institute of Public Health 2006). HA includes an

active engagement with life, optimal cognitive and

physical functioning and low risk of disease that

enables older people to participate within their

capacities (Hansen-Kyle, 2005). In many countries,

programs and policies are being implemented to

promote healthy and active aging, such as extending

the working (Hofäcker, 2014, Hofäcker and

Naumann, 2015). Innovative solutions, such as

Information and Communication Technologies

(ICT), are also promoted for supporting HA (Pew

Research Center, 2014).

The rapid development of ICT dedicated to

health and wellbeing (ehealth) offers an

unprecedented potential to assist, maintain and

improve older adults living active, healthier and

longer. eHealth facilitates access to health

information and could thus contribute to empower,

engage, and educate older adults (Hall et al., 2012).

eHealth interventions can also allow older adults to

receive timely health and social care in their homes,

which diminishes the burden on them and their

216

Gagnon, M-P., Buyl, R., Giguère, A., Éthier, S., Lechasseur, K. and Bourbonnais, A.

e-Health for Healthy Aging: Putting the Evidence into Practice .

DOI: 10.5220/0006371502160219

In Proceedings of the 3rd International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2017), pages 216-219

ISBN: 978-989-758-251-6

informal caregivers. Therefore, ehealth interventions

are gaining more and more attention as promising

solutions to support HA.

There were almost 260,000 health and medical

smartphone applications (apps) available

in 2016,

and more than 500 million smartphone users

worldwide used a healthcare app

(Research2Guidance, 2016). Older adults are

increasingly using these applications to help

themselves to stay fit, monitor their health status or

communicate with their healthcare providers.

However, little scientific evidence is available on the

effectiveness of ehealth interventions for HA.

Previous systematic reviews have focused on

specific types of interventions, such as exergames

(Larsen et al., 2013 ) or specific health issues such

as mental health (Preschl et al., 2011), but no

comprehensive reviews of ehealth interventions for

HA were available up to now.

We recently completed a systematic review to

fill this gap (Gagnon et al. 2016) that provides an

overview of the current evidence on ehealth

interventions for HA. The results show that ehealth

interventions can improve specific dimensions of

health and wellbeing among older adults.

This review also provides information on the

acceptability of ehealth interventions and other

implementation aspects that could inform those

responsible for promoting and supporting their use.

2 OBJECTIVES

This knowledge translation project aims to: 1)

synthesise the current scientific evidence on ehealth

interventions fostering HA in a language and format

that are adapted to the needs of older adults and their

informal caregivers, health and social care

professionals and decision makers; 2) develop and

implement educational material specifically targeted

to each of these groups in order to answer an unmet

need in offering a unique, timely and

interdisciplinary approach to understand the role of

ehealth for HA.

3 METHODS

This knowledge translation (KT) project is based on

a multidisciplinary collaborative approach between

researchers and knowledge users (Baumbusch et al.,

2008). We will adapt proven KT strategies with

knowledge users’ input. Three key groups of

knowledge users are involved: older adults and their

family/informal caregivers; health and social care

providers; and decision-makers.

3.1 Knowledge that will be

Disseminated

In order to translate evidence from the systematic

review into coherent information and education

material, we have identified the most promising

interventions in terms of benefits on important

outcomes for older adults. We expect to prioritize

two types of e-health interventions, based on the

strength of the scientific evidence found in the

systematic review, preferences of knowledge users

and feasibility of interventions. According to the

results of the systematic review, priority areas for e-

health interventions supporting HA are: 1) Use of

computers/social networks for improving mental

health and wellbeing in older adults; and 2)

Interactive online programs for promoting healthy

lifestyle in older adults.

3.2 KT Strategies

The first KT strategy consists of an evidence brief

summarizing findings from the systematic review on

ehealth interventions for HA that will be

disseminated to health and social care policy makers

and managers. The second KT strategy will provide

an interdisciplinary elearning program for health and

social care professionals on ehealth interventions for

HA, including practical information material based

on scientific evidence and developed with the input

of older adults. The third KT strategy is the

development of adapted web content and videos

targeting informal caregivers, family members and

older adults in order to increase their knowledge and

comfort with the use of ehealth technologies based

on their preferences and specific needs.

All three strategies are based on evidence on

effective KT methods, and we will use different

layouts in order to maximize their potential impact.

The first strategy is the production of an the

evidence brief written in a clear and non-technical

language that will provide information about e-

health interventions with added value in terms of

benefits on important outcomes for older adults.

Evidence briefs are efficient channels to translate

evidence into relevant knowledge for these groups

(Moat et al., 2014).

The second KT strategy consists in developing

online educational material, designed with the

collaboration of health and social care providers and

the input of older adults, that will present

contextualized evidence from the systematic review

e-Health for Healthy Aging: Putting the Evidence into Practice

217

adapted to various contexts and situations of

interdisciplinary work. Given the scarcity of such

training material, and the involvement of end users

in the development, we believe that many groups

could be interested in the use of this educational

material. For instance, health and social care

professional associations could include this material

into their continuing education program.

The third KT strategy will have two distinct

components: a) an interactive website providing a

knowledge exchange platform and, b) the production

of short videos (about two minutes) targeting older

adults and their informal caregivers. The website

will allow to reach a larger audience, while

facilitating knowledge sharing with various

stakeholder groups, including elderly people. To

make information accessible to the population, we

will make sure to use clear and non-technical

language. In addition, the web platform will allow

visitors to share comments on the material presented

and suggest ideas about innovative technologies that

could be further explored for scientific evidence on

their effectiveness. This dynamic KT strategy will

provide an open innovation platform that could also

inform future research and technological

developments based on users’ input. For their part,

the videos will be created with input from older

adults and informal carers recruited with the help of

our partners. They will summarize scientific

evidence on the main benefits associated with

featured technology, which specific groups could

particularly benefit from it, and any adverse effects

documented. The videos will be accessible from the

interactive website mentioned above.

3.3 Implementation Issues

The participation of target groups in the KT

strategies will help to adapt knowledge to the

Canadian context and the needs of each stakeholder

groups concerned by HA. This will be possible due

to interactive exchanges with the knowledge user

groups. First, the specific ehealth interventions

targeted in the KT strategies will be validated at the

beginning of the project with representatives of older

adults and informal caregivers. Their input will be

sought in identifying the important outcomes to be

documented in the KT strategies. These

interventions will also be the focus of educational

material, provided in the form of interdisciplinary

online training modules, developed with the input of

health and social care providers.

Second, the elearning modules will be

developed with the input of health and social care

professionals, older adults and informal caregivers.

The support of community partners involved in this

project will allow us to develop effective KT

strategies in addition to giving us access to a wide

network of stakeholders involved or concerned by

the issues addressed by our research project.

Feedback collected through the evaluation of the KT

strategies could directly inform the next phases of

this research that will consist in disseminating the

information and training material to a larger scale.

The participation of different stakeholders in the

project will also favour sharing of experience and

ideas, notably through the interactive web platform,

that could inform the development of novel e-health

interventions to support HA.

3.4 Evaluation of KT Strategies

We will assess KT strategies targeting older adults,

informal caregivers and family members through

focus groups with them. We plan to hold four groups

of about six to eight people each to discuss their

experience with the use of the interactive website

and videos, according to their preferences and

specific context (e.g. Was the material easy to

understand and relevant? Were the format and the

means used convenient?). We will collect

information on how they apply knowledge on e-

health interventions in their daily life and any

challenge they have encountered. Participants to

focus groups will be recruited with the collaboration

of our community partners.

The training modules will be evaluated by

means of an assessment of the health and social care

professionals’ knowledge acquisition, self-directed

learning readiness (SDLR) and satisfaction with the

overall content quality, user-friendliness,

applicability and relevance of the training material.

A web-based questionnaire adapted from our

previous evaluation of elearning material

will be

used to assess learners’ knowledge and SDLR before

and after the completion of the training modules, and

their satisfaction will be assessed after their

completion of the program. To evaluate the impact

of the dissemination strategy targeted at decision

makers, we will document the number of downloads

of the evidence brief, and track its use in policy

documents in the two years following its

publication.

4 EXPECTED RESULTS

The results of our systematic review provide

evidence for decision makers on effective ehealth

interventions that could be implemented in order to

ICT4AWE 2017 - 3rd International Conference on Information and Communication Technologies for Ageing Well and e-Health

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promote health and wellbeing in older adults. They

can also inform training programs for health and

social care workers on the use of ehealth in caring

for the elderly. These results are particularly relevant

for informal caregivers, family members and older

adults themselves who need reliable information on

the opportunities offered by ehealth for supporting

health and wellbeing. Thus, this project will allow

translating the best scientific evidence on effective

ehealth interventions for HA to inform decision-

makers, providers, older adults and informal

caregivers through strategies that are adapted to each

of these groups.

5 CONCLUSIONS

Given the huge challenges associated with

population aging worldwide, ehealth can be seen as

one of the strategies that could improve active and

healthy aging. It is thus important that effective

ehealth interventions are implemented for the benefit

of older adults and their informal caregivers, but also

the society as a whole. The knowledge derived from

this project will contribute to: 1) disseminating

evidence about ehealth interventions to the aging

population; 2) rising awareness of health and social

care professionals regarding ehealth interventions

that have proven to be effective and acceptable for

older adults; and 3) promoting policy options on

ehealth interventions for HA among decision

makers.

ACKNOWLEDGEMENT

This project is funded through a Dissemination grant

from the Canadian Institutes for Health Research.

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