Is Old-Age Diversity Underrepresented In Research On Digital Health Technologies?

Introduction: Much research is conducted for evaluating digital-based solutions for healthcare. However, little is known about the extent to which such evaluations succeed in representing the diversity that characterises old age. We present an analysis of participation in two evaluations of digital-based interventions: (a) an exergaming programme for improving physical activity among individuals with heart failure, and (b) a mobile-based monitoring of post-operative progress of individuals who underwent a day surgery. Methods: Participation is conceptualised as resulting from three processes of selection of individuals: pre-screening (i.e. individuals are or are not screened for participation), recruitment (i.e. individuals are in- or excluded due to study criteria), self-selection (i.e. individuals decide to participate or not). Based on field information and survey data, we modelled (1) the (non-)participation and (2) the individual decision to participate (or not) in the two evaluations. Results: Main findings indicated that increasing age enhances the likelihood of not being screened, not recruited or to decline the invitation to participate, and those not recruited were most often ineligible because of technology-related barriers (e.g., no or insufficient mobile phone), time constrains, and health limitations. Decliners and those who decided to participate differ along the lines of age, gender, job, health status, and digital skills.