Examining Identity as a Variable of Health Technology Research for OlderAdults: A Systematic Review

Title of the Paper

Examining Identity as a Variable of Health Technology Research for Older Adults: A Systematic Review

Paper Information

• Thematic Area: Identity as a variable in HCI and health technology research
• Keywords: Older adult health, ubiquitous computing, cultural diversity, identity dimensions, systematic literature review, technology design, user participation

Research Background and Issues

• Identified Problems or Challenges:
  1. Older adults, particularly those from socially marginalized groups (e.g., racial, economic, gender), exhibit low acceptance and usage rates of health-related technologies.
  2. HCI research often treats older adults as a homogeneous group, neglecting identity dimensions and their impact on technological needs.
  3. A lack of understanding of specific identity dimensions (e.g., race, socioeconomic status) among older adults may result in technologies that fail to meet their actual needs, exacerbating health inequities.
• Significance: This research aims to design more inclusive health technologies for historically excluded groups, improving health outcomes for older adults and reducing inequalities in technology adoption.
• Research Motivation and Related Work: Building on cutting-edge research in sociology and HCI, this study seeks to understand identity dimensions in older adults' technology use while emphasizing synchronicity and diversity in HCI.

Solutions

• Proposed Methods or Solutions:
  1. Systematic Review: Analyzed 174 HCI health technology-related papers published between 2008 and 2020.
  2. Identity Dimension Classification: Researchers categorized identity dimensions into primary dimensions (e.g., age, gender, race, physical ability) and secondary dimensions (e.g., educational background, language).
  3. Data Extraction and Coding Analysis: Standardized extraction of research methods, reporting of identity variables, target populations, and research outcomes from the literature.
• Innovative Contributions:
  1. Clarified the impact of identity dimensions on health technology design and, for the first time, discussed this issue from a multidimensional, systematic perspective.
  2. Analyzed research methods and participation approaches specific to older adults as subjects in health technology research within HCI.
  3. Proposed methodological recommendations for inclusive technology design, such as employing critical theoretical frameworks (e.g., intersectionality theory) to examine research practices.

Research Findings

• Specific Findings:
  1. Mainstream research on identity dimensions is largely limited to age and gender (>70%), with low reporting rates for dimensions such as race (10.6%) and income (3.7%).
  2. Historical marginalization of older adults (e.g., low-income, minority groups) is rarely addressed in sampling.
  3. From 2008 to 2020, the comprehensiveness and standardization of reporting identity dimensions in older adult health technology research showed no significant improvement.
• Strengths:
  1. Provided detailed data analysis (e.g., temporal trends, methodological usage, frequency of identity dimension reporting).
  2. Highlighted limitations in research methods (e.g., underreporting of race and geographic factors leading to potential inequities).
• Experimental or Evaluation Results:
  1. Evaluated patterns in the reporting of identity matrices in HCI research; most studies oversimplify the identity characteristics of older adults.
  2. Identified emerging trends: since 2017, a few studies have begun exploring the interactive use of individual diversity dimensions, though overall progress remains limited.
• Limitations and Future Directions:
  1. The sample of literature was limited to ACM and IEEE databases, potentially overlooking high-quality work from other domains.
  2. Excluded cross-cultural (non-English) research, possibly limiting a global perspective.
  3. Advocated for future integration of intersectionality theory and critical race theory to understand the role of real-world identity dimensions in health technology design.
  4. Called for greater community participation and reflective practices to ensure research methods and design outcomes are more equitable.