BACKGROUND: Older adults want to preserve their health and autonomy and stay in their own home environment for as long as possible. This is also of interest to policy makers who try to cope with growing staff shortages and increasing health care expenses. Ambient assisted living (AAL) technologies can support the desire for independence and aging in place. However, the implementation of these technologies is much slower than expected. This has been attributed to the lack of focus on user acceptance and user needs.OBJECTIVE: The aim of this study is to develop a theoretically grounded understanding of the acceptance of AAL technologies among older adults and to compare the relative importance of different acceptance factors.METHODS: A conceptual model of AAL acceptance was developed using the theory of planned behavior as a theoretical starting point. A web-based survey of 1296 older adults was conducted in the Netherlands to validate the theoretical model. Structural equation modeling was used to analyze the hypothesized relationships.RESULTS: Our conceptual model showed a good fit with the observed data (root mean square error of approximation 0.04; standardized root mean square residual 0.06; comparative fit index 0.93; Tucker-Lewis index 0.92) and explained 69% of the variance in intention to use. All but 2 of the hypothesized paths were significant at the P<.001 level. Overall, older adults were relatively open to the idea of using AAL technologies in the future (mean 3.34, SD 0.73).CONCLUSIONS: This study contributes to a more user-centered and theoretically grounded discourse in AAL research. Understanding the underlying behavioral, normative, and control beliefs that contribute to the decision to use or reject AAL technologies helps developers to make informed design decisions based on users' needs and concerns. These insights on acceptance factors can be valuable for the broader field of eHealth development and implementation.
Recent years have shown the emergence of numerous local energy initiatives (prosumer communities) in the Netherlands. Many of them have set the goal to establish a local and sustainable energy provision on a not-for-profit basis. In this study we carried out exploratory case studies on a number of Dutch prosumer communities. The objective is to analyse their development process, to examine the barriers they encounter while organising their initiative, and to find how ICT could be applied to counteract these barriers and support communities in reaching their goals. The study shows that prosumer communities develop along a stepwise, evolutionary growth path, while they are struggling with organising their initiative, because the right expertise is lacking on various issues (such as energy technology, finance and legislation). Participants stated that, depending on the development phase of their initiative, there is a strong need for information and specific expertise. With a foreseeable growing technical complexity they indicated that they wanted to be relieved with the right tools and services at the right moment. Based on these findings we developed a generic solution through the concept of a prosumer community shopping mall. The concept provides an integrated and scalable ICT environment, offering a wide spectrum of energy services that supports prosumer communities in every phase of their evolutionary growth path. As such the mall operates as a broker and clearing house between 2 prosumer communities and service providers, where the service offerings grow and fit with the needs and demands of the communities along their growth path. The shopping mall operates for many prosumer communities, thus providing economies of scale. Each prosumer community is presented its own virtual mall, with specific content and a personalised look-and-feel.
