Ray Brian Jones

Background: Digital technologies have the potential to support physical, cognitive, and social activity among older adults, but many small- and medium-sized enterprises (SMEs) lack the resources to conduct meaningful co-design with older adults. Toolkits derived from rigorous co-design processes may offer a scalable mechanism for translating end-user priorities into real-world product development. Objective: The Generating Older Active Lives Digitally study aimed primarily to engage older adults in a co-design process to identify priorities for digital technologies that support physical activity and reminiscence. Secondary objectives were to (1) translate these findings into a practical developer-facing toolkit, and (2) evaluate the toolkit’s perceived utility and influence among digital technology SMEs. Methods: A total of 157 participants (121 older, 7 younger, and 29 staff) across 15 community and care settings in England and Scotland engaged in 106 technology interaction sessions, 22 evaluation focus groups, and 10 co-design workshops. These involved more than 20 digital technologies. Thematic analysis and structured card-ranking tasks were used to derive their priorities. Preliminary toolkits were co-designed and used by 10 UK-based SMEs who received small grants to apply the toolkit to active development projects. Their reports and follow-up interviews were analyzed thematically to identify perceived impacts on design decisions, product adaptations, and business outcomes. Results: Co-design activities generated 7 cross-cutting themes: motivation, content, barriers, design and inclusivity, suitability, acceptability, and motivations to use. These were organized into 3 toolkit sections: general design principles, online physical-activity platforms, and virtual reality. SMEs reported that the toolkits enhanced understanding of older adults’ needs, validated design decisions, and inspired some new features. Perceived impacts included improved usability, expanded accessibility options, increased content variety, clearer instructional design, enhanced social components, and reduced operational costs. SMEs also reported some business benefits, including strengthened cases for investment and increased product uptake. Conclusions: Co-designed toolkits may offer a useful and cost-effective mechanism for translating older adults’ priorities into digital product development. SMEs perceived this toolkit as practical, relevant, and impactful for informing design choices. This approach may complement, but does not replace, direct user involvement. It may help accelerate inclusive digital-health innovation for aging populations.

Background: Online patient access to electronic records is expanding internationally but remains contested. Although practising clinicians’ concerns are well documented, less is known about the views of retired doctors who are more likely themselves to be patients. We explored the experience of retired doctors in accessing their own medical records as patients in the UK and Spain. Methods: We conducted an anonymous mixed-methods online survey of retired doctors aged 60 years and over in the UK and Spain. Participants reported their experiences of accessing their own medical records and their views on whether online access should be available to all patients. Quantitative analyses examined factors associated with support; free-text responses were analysed thematically. Results: Two hundred retired doctors participated (UK n=92; Spain n=108). Overall, 64% supported online access to health records for all patients, with no clear difference between countries. This proportion was higher than that reported in a previous survey of practising general practitioners in England, in which approximately one-third regarded online record access as a good idea; however, the studies involved different populations and sampling approaches and were not designed for a formal comparison. In adjusted analysis, having previously accessed one’s own medical record was associated with greater support for online access for all patients (odds ratio 4.74, 95% confidence interval 1.80–12.53). Age, gender, former professional setting and country showed no clear independent associations with support. Participants described benefits including patient empowerment, transparency, error correction and greater efficiency, alongside concerns about misinterpretation, anxiety and handling of sensitive information. Conclusions: In this cross-sectional convenience sample, retired doctors were more supportive of online access to health records than practising English GPs have reported in previous surveys. This cross-study difference cannot establish whether attitudes differ because of retirement, patient experience, professional role, sampling or other contextual factors. However, the association between having accessed one’s own record and support for access is consistent with the hypothesis that experience from the patient perspective may influence professional attitudes. Prospective comparative research is needed to examine this temporal relationship and to assess how record presentation and explanatory support affect patient and clinician experiences.

Background : The use of digital technology for supporting physical activity (PA) in older adults has increased recently despite the paucity of research exploring perceptions and age-appropriateness of these technologies. Methods : Older adults (n = 120) residing in care homes (n = 45) and living independently (n = 75) in England and Scotland, as well as care home staff (n = 30) and young adults (n = 7) appraised a variety of different PA technologies (eg, online and digital platforms, exergames, and virtual reality headsets) through a multiphase approach. Technologies were presented as a “menu” to participants to select at interactive sessions. Feedback was collected through focus groups, interviews, codesign workshops, and field notes, all analyzed thematically. Participant characteristics including PA levels and familiarity with technology were collected via questionnaire at baseline and after appraising selected technologies. Results : Qualitative findings explored 6 overarching themes: (1) recognizing the potential of technology, (2) suitability of PA technology, (3) barriers to using PA technology, (4) motivation to engage with digital technology, (5) content suggestions for future PA technology, and (6) preferences for PA technology delivery. PA engagement and prior experience with digital technologies varied greatly at baseline. Overall, participants’ perceptions and appraisal of the PA technologies varied according to their context and setting, prior experience with technology, and PA engagement. Quantitative data were challenging to gather, with complete data available from only 18% out of those consented. Conclusions : Older adults in this study demonstrated a keen interest in digital technologies for PA, but context- and health-related barriers for engagement with these tools need addressing.

BACKGROUND Digital technologies have the potential to support physical, cognitive, and social activity among older adults, but many small and medium-sized enterprises (SMEs) lack the resources to conduct meaningful codesign with end-users. Toolkits derived from rigorous codesign processes may offer a scalable mechanism for translating end-user priorities into real-world product development. OBJECTIVE This study aimed to (1) engage older adults in an extensive codesign process to identify priorities for digital technologies that support physical activity and reminiscence, (2) translate these findings into a practical developer-facing toolkit, and (3) evaluate the toolkit’s perceived utility and influence among digital technology SMEs. METHODS 157 participants (120 older, 7 younger, and 30 staff) across 15 community and care settings in England and Scotland engaged in 106 technology interaction sessions, 22 evaluation focus groups and 10 codesign workshops involving more than 20 digital technologies. Thematic analysis and structured card-ranking tasks were used to derive end-user priorities. Preliminary toolkits were created and provided to 10 UK-based SMEs who received small grants to apply the toolkit to active development projects. Developer reports and follow-up interviews were analysed thematically to identify perceived impacts on design decisions, product adaptations, and business outcomes. RESULTS Codesign activities generated seven cross-cutting themes: motivation, content, barriers, design and inclusivity, suitability, acceptability, and motivations to use. These were organised into three toolkit sections: general design principles, online physical-activity platforms, and virtual reality. Developers reported that the toolkits enhanced understanding of older adults’ needs, validated design decisions, and inspired new features. Reported impacts included improved usability, expanded accessibility options, increased content variety, clearer instructional design, enhanced social components, and reduced operational costs. SMEs also reported business benefits, including strengthened cases for investment and increased product uptake. CONCLUSIONS Codesign-derived toolkits offer a scalable and cost-effective mechanism for translating older adults’ priorities into digital product development. SMEs perceived the toolkit as practical, relevant, and impactful for informing design choices. This approach complements, but does not replace, direct user involvement and may help accelerate inclusive digital-health innovation for ageing populations. CLINICALTRIAL n/a

Background: Social care systems worldwide face increasing demographic and financial pressures. This necessitates exploring innovative technological solutions to enhance service delivery without substantially increasing costs. Conversational interfaces, including interactive voice response, chatbots, and voice assistants, have gained traction as a means to improve accessibility and efficiency in social care. The rapid development of large language models such as ChatGPT has further accelerated interest in conversational artificial intelligence (AI). These technologies can offer intuitive interactions, particularly for individuals with limited digital literacy. However, their real-world impact, usability, and ethical considerations in social care remain underexplored. Objective: This scoping review aims to synthesize existing literature on the implementation, evaluation, and impact of conversational AI systems within social care settings for older adults. The review will identify best practices, current gaps, and future directions for research and implementation. Key research questions include the following: how are conversational systems implemented on a technical level, and how do older adults and their support systems use them in a social care context? What methods are used to evaluate acceptability, usability, and the impact of broad well-being in the context of older adults’ social care? and What are conversational technologies’ acceptability, usability, and well-being impact in the context of older adults’ social care? Methods: The review will follow the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and Population, Concept, and Context (PCC) frameworks. A systematic search will be conducted across five databases (IEEE, Web of Science, PubMed, ACM, and Scopus) for English-language articles published from 2019 onward. Studies will be included if they empirically examine conversational systems’ implementation, evaluation, or impact for older adults (aged ≥55 years) within a social care context. Two independent reviewers will screen articles and extract data. A descriptive analysis will then categorize findings across key domains such as accessibility, usability, ethical considerations, and well-being outcomes. Results: The results will be included in the scoping review, which began in March 2025. The analysis is underway and is expected to be completed and submitted for publication by September 2025. Conclusions: This scoping review will provide an overview of the role of conversational AI in social care, highlighting both opportunities and challenges in implementation. By synthesizing existing research, the review will inform future developments in the use of conversational agents to improve social inclusion, engagement, and well-being among older adults. International Registered Report Identifier (IRRID): PRR1-10.2196/72310

BACKGROUND Social care systems worldwide face increasing demographic and financial pressures. This necessitates exploring innovative technological solutions to enhance service delivery without substantially increasing costs. Conversational interfaces, including interactive voice response, chatbots, and voice assistants, have gained traction as a means to improve accessibility and efficiency in social care. The rapid development of large language models such as ChatGPT has further accelerated interest in conversational artificial intelligence (AI). These technologies can offer intuitive interactions, particularly for individuals with limited digital literacy. However, their real-world impact, usability, and ethical considerations in social care remain underexplored. OBJECTIVE This scoping review aims to synthesize existing literature on the implementation, evaluation, and impact of conversational AI systems within social care settings for older adults. The review will identify best practices, current gaps, and future directions for research and implementation. Key research questions include the following: how are conversational systems implemented on a technical level, and how do older adults and their support systems use them in a social care context? What methods are used to evaluate acceptability, usability, and the impact of broad well-being in the context of older adults’ social care? and What are conversational technologies’ acceptability, usability, and well-being impact in the context of older adults’ social care? METHODS The review will follow the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) and Population, Concept, and Context (PCC) frameworks. A systematic search will be conducted across five databases (IEEE, Web of Science, PubMed, ACM, and Scopus) for English-language articles published from 2019 onward. Studies will be included if they empirically examine conversational systems’ implementation, evaluation, or impact for older adults (aged ≥55 years) within a social care context. Two independent reviewers will screen articles and extract data. A descriptive analysis will then categorize findings across key domains such as accessibility, usability, ethical considerations, and well-being outcomes. RESULTS The results will be included in the scoping review, which began in March 2025. The analysis is underway and is expected to be completed and submitted for publication by September 2025. CONCLUSIONS This scoping review will provide an overview of the role of conversational AI in social care, highlighting both opportunities and challenges in implementation. By synthesizing existing research, the review will inform future developments in the use of conversational agents to improve social inclusion, engagement, and well-being among older adults. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/72310

BACKGROUND Many ‘toolkits’ for developers have been designed but are sometimes criticised for their tokenistic approach. Few have been assessed for impact in real-world settings. Based on thematic analysis of 135 codesign workshops four preliminary toolkits were produced to help developers of digital products aiming to keep older people active. OBJECTIVE Many ‘toolkits’ for developers have been designed but are sometimes criticised for their tokenistic approach. Few have been assessed for impact in real-world settings. Based on thematic analysis of 135 codesign workshops four preliminary toolkits were produced to help developers of digital products aiming to keep older people active. METHODS Many ‘toolkits’ for developers have been designed but are sometimes criticised for their tokenistic approach. Few have been assessed for impact in real-world settings. Based on thematic analysis of 135 codesign workshops four preliminary toolkits were produced to help developers of digital products aiming to keep older people active. RESULTS Ten organizations including charitable sector organizations and small businesses were each awarded £5000 to use the toolkits in mini projects to improve their product functionality. Their proposals included digital music and movement, reminiscence, social connectedness, and directory type products. Developers were already broadly aware of many considerations presented but using the toolkist gave them confidence in what they were doing. Using toolkits also enabled developers to demonstrate that they were working with university teams, so instilling client confidence. Toolkits were used for horizon scanning where developers were considering moving into new product areas and prioritising on improving existing products. Developers reported impacts including 1) better integration and ability to scale up their services; 2) provision of more detailed evaluation and reporting to clients; 3) more useable and appropriate products. These improvements enabled retention and increase in client bases, widening of collaborations, and further funding for product development given their improved confidence. However, developers reported that the funding to use the toolkits for the mini projects was the key catalyst for change. For some, lack of funding (i.e. just toolkit provision) would have meant change occurred at a slower pace, and the quality of development might have been reduced. CONCLUSIONS These preliminary toolkits provided prompts and ideas for the better design of digital products to keep older people active. These toolkits, developed with stakeholders, provide a useful complementary method of learning from the experience of others where designers may not have access to target populations or resources for codesign. The toolkits gave developers and their clients confidence in their work to improve functionality and with the funding helped them improve their products. As part of a mix of different types of support that developers might need, the toolkits can help developers produce products more relevant for older people. The toolkits have subsequently been refined and are available for others to use to help keep older people physically and socially active. CLINICALTRIAL

Virtual reality (VR) can support healthy ageing, but few devices have been trialed with frail older adults to increase physical activity. We conducted a preliminary mixed-methods implementation evaluation of an omnidirectional VR treadmill and a static VR experience with seven older adults over a six-week period in a supported living facility. Frequency of use and pre-post physical functioning measures were collected, mainly to establish technology suitability based on person characteristics. Diary entries following technology use, resident focus group and staff interview revealed technology acceptance and perceived potential for increasing physical activity, health and wellbeing through accessing virtual environments, which motivated continued activity. Results demonstrated technology suitability for a range of older adults with various mobility and physical impairments. However, residents noted interest in a seated treadmill for physical activity without perceived risks of falls with standing treadmills. Staff raised considerations around care home implementations including usability, cost and space.