Barriers and facilitators to implementing assistive technologies to support paid and unpaid care for older adults: a Technology Acceptance Model-informed systematic review. (Preprint)

• DOI: 10.2196/preprints.73917
• Publication Date: 2025-03-27T12:11:27Z
• Authors: Stephen Malden; Kris McGill; Bruce Guthrie; Helen Frost; Susan D Shenkin; Adanna Ezike; Beth Bareham; Stewart W Mercer; Caroline Pearce; Cara Wilson; Ian Underwood; John Vines; Sue Lewis; Amy O'Donnell

BACKGROUND Assistive technologies (AT) are used increasingly in community settings for the management of older adults’ health and care. Despite a rapid increase in the capabilities and uptake of these technologies, gaps remain in understanding main barriers to their usage.

OBJECTIVE This systematic review investigated the barriers and facilitators to the use of AT in the care of older adults. PROSPERO: CRD42021266656.

METHODS Six electronic databases were searched from January 2011 to March 2024. Primary studies were included if they used qualitative methods reporting findings related to barriers or facilitators to the implementation of AT for older adults (from the perspective of either carers or older adults) in community settings. All data were screened independently by two reviewers. Study quality was assessed using the Critical Appraisal Skills Programme (CASP). Data from each included study were synthesized using thematic synthesis, before barriers were mapped against the domains of the Technology Acceptance Model.

RESULTS Ninety-five studies were included in the review. Ten barriers - privacy, cost, insufficient knowledge, fear of misuse, usability, poor functionality, perceived lack of need, stigma and lack of human interaction were identified, as well as three facilitators –awareness of health benefits, targeted training, and user-centred design. Volume of output in the field of barriers to AT use has increased three-fold post COVID-19 in comparison to the previous decade. Persistent barriers relating to all domains of the technology Acceptance Model were identified, with the majority of these relating to the ‘behavioural intention to use’ domain. The majority of studies had a moderate/high risk of bias.

CONCLUSIONS There remain distinct barriers to sustained usage of AT for the care of older adults, particularly concerning adoption as defined by the Technology Acceptance Model. Further studies investigating the acceptability of ATs are needed to increase understanding of optimization strategies.