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JMIR Aging

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Journal Description

JMIR Aging (JA, Founding Editor-in-chief: Jing Wang, Cizik School of Nursing, Houston TX, USA) is a new sister journal of JMIR (the leading open-access journal in health informatics (Impact Factor 2016: 5.175), focusing on technologies, medical devices, apps, engineering, informatics applications and patient education for medicine and nursing, education, preventative interventions and clinical care / home care for elderly populations. In addition, aging-focused big data analytics using data from electronic health record systems, health insurance databases, federal reimbursement databases (e.g. U.S. Medicare and Medicaid), and other large databases are also welcome.  

As open access journal we are read by clinicians, nurses/allied health professionals, informal caregivers and patients alike and have (as all JMIR journals) a focus on readable and applied science reporting the design and evaluation of health innovations and emerging technologies. We publish original research, viewpoints, and reviews (both literature reviews and medical device/technology/app reviews).

During a limited period of time, there are no fees to publish in this journal. Articles are carfully copyedited and XML-tagged, ready for submission in PubMed Central.

Be a founding author of this new journal and submit your paper today!

 

Recent Articles:

  • Source: iStock by Getty Images; Copyright: vgajic; URL: https://www.istockphoto.com/ca/photo/mature-businessman-doing-blood-sugar-test-in-his-office-gm870234212-145307555; License: Licensed by the authors.

    Diabetes Online Community User Perceptions of Successful Aging With Diabetes: Analysis of a #DSMA Tweet Chat

    Abstract:

    Background: According to the American Diabetes Association, there are approximately 30.3 million Americans with diabetes, and the incidence is growing by nearly 1.5 million cases per year. These individuals are at particularly high risk of developing secondary comorbid conditions related to diabetes and aging. Nearly 45% of individuals aged 65 to 75 years use social media, and this number is steadily growing. The use of social media provides the opportunity to assess the perceptions and needs of this population. Objective: The purpose of this study was to examine stakeholder perceptions of successful aging with diabetes. Methods: This study presents a retrospective analysis of a tweet chat focused on aging with diabetes. Tweets were collected using Symplur Signals data analytics software (Symplur LLC) and analyzed for content analysis, sentiment, and participant demographics. Two authors reviewed discussion posts for accuracy of analysis. Results: A total of 59 individuals participated in this tweet chat generating 494 tweets and nearly 2 million impressions. Most (36/59, 63%) tweet chat participants were people living with diabetes; 25% (14/59) were caregivers and advocates. Seven countries were represented in the conversation. A majority (352/494, 71.3%) of the tweets indicated positive sentiment related to aging with diabetes. Five major themes emerged from the qualitative analysis: (1) personal decline now and in the future, (2) limited access to treatment, (3) inability to provide self-care, (4) health care provider capacity to support aging with diabetes, and (5) life-long online peer health support to facilitate diabetes management. Conclusions: Individuals with diabetes are living longer and want to be supported with specialized care and access to technology that will allow them to successfully age. Aging- and diabetes-related changes may complicate diabetes management into old age. People with diabetes desire options including aging in place; therefore, special training for care partners and health care providers who care for older adults is needed.

  • The McMaster Optimal Aging Portal web resource rating. Source: Image created by the Authors; Copyright: The McMaster Optimal Aging Portal; URL: http://aging.jmir.org/2018/1/e3/; License: Licensed by JMIR.

    A Tool That Assesses the Evidence, Transparency, and Usability of Online Health Information: Development and Reliability Assessment

    Abstract:

    Background: The internet is commonly used by older adults to obtain health information and this trend has markedly increased in the past decade. However, studies illustrate that much of the available online health information is not informed by good quality evidence, developed in a transparent way, or easy to use. Furthermore, studies highlight that the general public lacks the skills necessary to distinguish between online products that are credible and trustworthy and those that are not. A number of tools have been developed to assess the evidence, transparency, and usability of online health information; however, many have not been assessed for reliability or ease of use. Objective: The first objective of this study was to determine if a tool assessing the evidence, transparency, and usability of online health information exists that is easy and quick to use and has good reliability. No such tool was identified, so the second objective was to develop such a tool and assess it for reliability when used to assess online health information on topics of relevant to optimal aging. Methods: An electronic database search was conducted between 2002 and 2012 to identify published papers describing tools that assessed the evidence, transparency, and usability of online health information. Papers were retained if the tool described was assessed for reliability, assessed the quality of evidence used to create online health information, and was quick and easy to use. When no one tool met expectations, a new instrument was developed and tested for reliability. Reliability between two raters was assessed using the intraclass correlation coefficient (ICC) for each item at two time points. SPSS Statistics 22 software was used for statistical analyses and a one-way random effects model was used to report the results. The overall ICC was assessed for the instrument as a whole in July 2015. The threshold for retaining items was ICC>0.60 (ie, “good” reliability). Results: All tools identified that evaluated online health information were either too complex, took a long time to complete, had poor reliability, or had not undergone reliability assessment. A new instrument was developed and assessed for reliability in April 2014. Three items had an ICC<0.60 (ie, “good” reliability). One of these items was removed (“minimal scrolling”) and two were retained but reworded for clarity. Four new items were added that assessed the level of research evidence that informed the online health information and the tool was retested in July 2015. The total ICC score showed excellent agreement with both single measures (ICC=0.988; CI 0.982–0.992) and average measures (ICC=0.994; CI 0.991–0.996). Conclusions: The results of this study suggest that this new tool is reliable for assessing the evidence, transparency, and usability of online health information that is relevant to optimal aging.

  • Source: MyTools4Care / Placeit.net; Copyright: JMIR Publications; URL: http://aging.jmir.org/2018/1/e2/; License: Creative Commons Attribution (CC-BY).

    A Web-Based Intervention to Help Caregivers of Older Adults With Dementia and Multiple Chronic Conditions: Qualitative Study

    Abstract:

    Background: Caregivers (ie, family members and friends) play a vital role in the ongoing care and well-being of community-living older persons with Alzheimer disease and related dementia in combination with multiple chronic conditions. However, they often do so to the detriment of their own physical, mental, and emotional health. Caregivers often experience multiple challenges in their caregiving roles and responsibilities. Recent evidence suggests that Web-based interventions have the potential to support caregivers by decreasing caregiver stress and burden. However, we know little about how Web-based supports help caregivers. Objective: The objectives of this paper were to describe (1) how the use of a self-administered, psychosocial, supportive, Web-based Transition Toolkit, My Tools 4 Care (MT4C), designed by atmist, Edmonton, Alberta, Canada, helped caregivers of older adults with Alzheimer disease and related dementia and multiple chronic conditions; (2) which features of MT4C caregivers found most and least beneficial; and (3) what changes would they would recommend making to MT4C. Methods: This study was part of a larger multisite mixed-methods pragmatic randomized controlled trial. The qualitative portion of the study and the focus of this paper used a qualitative descriptive design. Data collectors conducted semistructured, open-ended, telephone interviews with study participants who were randomly allocated to use MT4C for 3 months. All interviews were audio-taped and ranged from 20 to 40 min. Interviews were conducted at 1 and 3 months following a baseline interview. Qualitative content analysis was used to analyze collected data. Results: Fifty-six caregivers from Alberta and Ontario, Canada, participated in either one or both of the follow-up interviews (89 interviews in total). Caregivers explained that using MT4C (1) encouraged reflection; (2) encouraged sharing of caregiving experiences; (3) provided a source of information and education; (4) provided affirmation; and for some participants (5) did not help. Caregivers also described features of MT4C that they found most and least beneficial and changes they would recommend making to MT4C. Conclusions: Study results indicate that a self-administered psychosocial supportive Web-based resource helps caregivers of community-dwelling older adults with Alzheimer disease and related dementia and multiple chronic conditions with their complex caregiving roles and responsibilities. The use of MT4C also helped caregivers in identifying supports for caring, caring for self, and planning for future caregiving roles and responsibilities. Caregivers shared important recommendations for future development of Web-based supports.

  • Source: Freepik; Copyright: pressfoto; URL: https://www.freepik.com/free-photo/man-with-stomachache_857942.htm; License: Public Domain (CC0).

    Coproduction of a Theory-Based Digital Resource for Unpaid Carers (The Care Companion): Mixed-Methods Study

    Abstract:

    Background: Family and other unpaid carers are crucial to supporting the growing population of older people that are living outside residential care with frailty and comorbidities. The burden associated with caring affects carers’ well-being, thus limiting the sustainability of such care. There is a need for accessible, flexible, and responsive interventions that promote carers’ coping and resilience, and hence support maintenance of the health, well-being, and independence of the cared-for person. Objective: This study aimed to coproduce a digital program for carers to promote resilience and coping through supporting effective use of information and other Web-based resources. Its overlapping stages comprised the following: understanding the ways in which Web-based interventions may address challenges faced by carers, identifying target behaviors for the intervention, identifying intervention components, and developing the intervention prototype. Methods: The study was informed by person-based theories of coproduction and involved substantial patient and public involvement. It drew on the Behavior Change Wheel framework to support a systematic focus on behavioral issues relevant to caring. It comprised scoping literature reviews, interviews, and focus groups with carers and organizational stakeholders, and an agile, lean approach to information technology development. Qualitative data were analyzed using a thematic approach. Results: Four behavioral challenges were identified: burden of care, lack of knowledge, self-efficacy, and lack of time. Local health and social care services for carers were only being accessed by a minority of carers. Carers appreciated the potential value of Web-based resources but described difficulty identifying reliable information at times of need. Key aspects of behavior change relevant to addressing these challenges were education (increasing knowledge and understanding), enablement (increasing means and reducing barriers for undertaking caring roles), and persuasion (changing beliefs and encouraging action toward active use of the intervention). In collaboration with carers, this was used to define requirements for the program. A resources library was created to link to websites, Web-based guidance, videos, and other material that addressed condition-specific and generic information. Each resource was classified according to a taxonomy itemizing over 30 different subcategories of need under the headings Care Needs (of the cared-for person), General Information and Advice, and Sustaining the Carer. In addition, features such as a journal and mood monitor were incorporated to address other enablement challenges. The need for proactive, personalized prompts emerged; the program regularly prompts the carer to revisit and update their profile, which, together with their previous use of the intervention, drives notifications about resources and actions that may be of value. Conclusions: The person-based approach allowed an in-depth understanding of the biopsychosocial context of caring to inform the production of an engaging, relevant, applicable, and feasible Web-based intervention. User acceptance and feasibility testing is currently underway.

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Latest Submissions Open for Peer-Review:

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  • Using Actigraphy to Predict Ecological Momentary Assessment of Cognition, Mood, and Fatigue in Older Adulthood

    Date Submitted: Jun 18, 2018

    Open Peer Review Period: Jun 21, 2018 - Aug 16, 2018

    Background: Quality of sleep has been associated with cognitive and mood outcomes in otherwise healthy older adults. However, most studies have evaluated sleep quality as aggregate and/or mean measure...

    Background: Quality of sleep has been associated with cognitive and mood outcomes in otherwise healthy older adults. However, most studies have evaluated sleep quality as aggregate and/or mean measures, rather than addressing the impact of previous night’s sleep on next-day functioning. Objective: This study evaluated the ability of previous night’s sleep parameters on self-reported mood, cognition, and fatigue to understand short-term impacts of sleep quality on next-day functioning. Methods: Seventy-three cognitively-healthy older adults (19 male, 54 female) completed seven days of phone-based self-report questions, along with 24-hour actigraph data collection. We evaluated a model of previous night’s sleep parameters as predictors of mood, fatigue, and perceived thinking abilities the following day. Results: Previous night’s sleep predicted fatigue in the morning and mid-day, as well as sleepy/drowsiness in the morning; however, sleep measures did not predict subjective report of mood or perceived thinking abilities the following day. Conclusions: These findings suggest that objectively-measured sleep quality from the previous night may not have a direct or substantial relationship with subjective reporting of cognition or mood the following day, despite frequent patient reports. Continued efforts to examine the relationship between cognition, sleep, and everyday functioning are encouraged.

  • Health Information Seeking Behaviors of Family Caregivers: An Analysis of the Health Information National Trends Survey

    Date Submitted: Jun 5, 2018

    Open Peer Review Period: Jun 6, 2018 - Aug 1, 2018

    Background: Family caregivers are essential to supporting the growing population of aging adults. Caregivers provide essential care and support and are often highly engaged in the pursuit of health in...

    Background: Family caregivers are essential to supporting the growing population of aging adults. Caregivers provide essential care and support and are often highly engaged in the pursuit of health information. Objective: The objective of this study was to examine health information seeking behaviors among caregivers, and to identify caregiver characteristics that contribute to difficulty in seeking health information. Methods: Data from the Health Information National Trends Survey 5, Cycle 1 (N=3181) were used to compare health information seeking of caregivers (n= 391) with non-caregivers (n= 2790). Results: Caregivers sought health information for themselves and others more often than non-caregivers. Caregivers used computers, smartphones, or other electronic means to find health information more frequently than non-caregivers. Among caregivers, non-whites, those with less education and those without a regular healthcare provider were less confident in seeking health information. Female caregivers experienced less difficulty seeking health information compared to male caregivers, and caregivers born outside of the US reported greater difficulty seeking health information. Conclusions: Our study highlights prevalence of health information seeking among caregivers, and the use of electronic means to find health information. Notable differences in difficulty and confidence in health information seeking exist between caregivers, indicating the need for more attention to socioeconomic status, gender, and immigration status. Findings can guide efforts to optimize caregivers’ health information seeking experiences.

  • Understanding Care Navigation by Older Adults with Multimorbidity: A Mixed–Methods Study Using Social Network Analysis and Framework Analysis

    Date Submitted: May 15, 2018

    Open Peer Review Period: May 18, 2018 - Jul 13, 2018

    Background: Health and social care systems were designed to be used primarily by people with single and acute diseases. However, a growing number of older adults are diagnosed with multiple long-term...

    Background: Health and social care systems were designed to be used primarily by people with single and acute diseases. However, a growing number of older adults are diagnosed with multiple long-term health conditions (LTCs). The process of navigating the intricacies of health and social care systems in order to receive appropriate care presents significant challenges for older people living with multiple LTCs, which in turn can negatively influence their well-being and quality of life. Objective: The long-term goal of this work is to design technology to assist people with LTCs in navigating health and social care systems. In order to do so, we must first understand how older people living with LTCs currently engage with and navigate their care networks. There is no published research that describes and analyses the structure of formal and informal care networks of older adults with multiple LTCs, the frequency of interactions with each type of care service, and the problems that typically arise in these interactions. Methods: A mixed-methods study was carried out. Sixty-two participants, all aged 55 years or over, living in England, with two or more LTCs, were recruited and completed a social network analysis (SNA) questionnaire. Semi-structured interviews were conducted with roughly a 10% subsample of the questionnaire sample; four women and three men. On average, interviewees were aged 70 years old and had four LTCs. Results: Personal care networks (PCNs) were complex and adapted to each individual. The task of building, and subsequently navigating, one’s PCN rested mainly on patients’ shoulders. It was frequently the patients’ task to bridge and connect the different parts of the system. The major factor leading to a satisfying navigation experience was found to be patients’ assertive, determined and proactive approaches. Smooth communication and interaction between different parts of the care system were found to lead to more satisfying navigation experiences. Conclusions: Technology to support care navigation for older adults with multiple LTCs needs to support patients in managing complex health and social care systems by effectively integrating management of multiple conditions and facilitating communication between multiple stakeholders, while also offering flexibility to adapt to individual situations. Since quality of care seems to be dependent on determination and ability of patient, this leads to uneven care. Those with less determination, and less organization skills experience worse care. Technology must aim to fulfil these coordination functions, to ensure care is equitable across those who need it, not just those who ask loudest.

  • Feasibility and conceptualization of an e-mental health treatment for depression in older adults.

    Date Submitted: May 4, 2018

    Open Peer Review Period: May 9, 2018 - Jul 4, 2018

    Background: In older adults depression is one of the most common mental disorders. Unfortunately, depression in older adults is often not being recognized. Objective: The aim of this study was to iden...

    Background: In older adults depression is one of the most common mental disorders. Unfortunately, depression in older adults is often not being recognized. Objective: The aim of this study was to identify how online applications can recognize and help treat depression in older adults. Methods: Focus groups were realized with mental health care expert (N = 8). An online survey with N = 56 older adults suffering from depression was carried out. Qualitative interviews were conducted with N = 2 individuals. Results: Results of the focus groups highlighted that there is a need for a collaborative care platform for depression in old age. Findings from the online study showed that younger participants (50 to 64 years) used electronic media more often than older participants (65 years and older). The interviews point in a comparable direction. Conclusions: Overall, an e-mental health treatment for depression in older adults would be well accepted. They should be developed, evaluated and in case of evidence for their effectiveness integrated in everyday clinic.

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