Overcoming challenges in smart phone use among older adults in Sa.pdf - Graduate Theses and Dissertations Iowa State University Capstones Theses and

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Unformatted text preview: Graduate Theses and Dissertations Iowa State University Capstones, Theses and Dissertations 2017 Overcoming challenges in smart phone use among older adults in Saudi Arabia Muath Alhussain Khawaji Iowa State University Follow this and additional works at: Part of the Computer Sciences Commons Recommended Citation Khawaji, Muath Alhussain, "Overcoming challenges in smart phone use among older adults in Saudi Arabia" (2017). Graduate Theses and Dissertations. 16155. This Dissertation is brought to you for free and open access by the Iowa State University Capstones, Theses and Dissertations at Iowa State University Digital Repository. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Iowa State University Digital Repository. For more information, please contact [email protected] Overcoming challenges in smart phone use among older adults in Saudi Arabia by Muath Alhussain I Khawaji A dissertation submitted to the graduate faculty in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Major: Human Computer Interaction Program of Study Committee: James H Oliver, Major Professor Richard T Stone Sunghyun Ryoo Kang Jonathan Kelly Doug W Jacobson The student author, whose presentation of the scholarship herein was approved by the program of study committee, is solely responsible for the content of the dissertation. The graduate college will ensure this dissertation is globally accessible and will not permit alterations after a degree is conferred. Iowa State University Ames, Iowa 2017 Copyright © Muath Alhussain I Khawaji, 2017. All rights reserved. ii TABLE OF CONTENTS ACKNOWLEDGMENTS ......................................................................................... iv ABSTRACT ……………………………….............................................................. v CHAPTER 1 INTRODUCTION .......................................................................... 1 Technology and Older People .............................................................................. Guidance on Smart Phone Interface Design for Senior Citizens ......................... Smart Phone Use in Saudi Arabia........................................................................ Theoretical Framework ........................................................................................ Purpose of Study and Research Questions .......................................................... Chapter Summary ............................................................................................... 2 3 4 4 5 7 CHAPTER 2 REVIEW OF LITERATURE ......................................................... 8 Introduction ......................................................................................................... Technology and the Ageing Process .................................................................... Challenges in the use of smart phones by seniors ............................................... Theories of Technology Adoption ...................................................................... The Influence of Culture and Language on Technology Adoption .................... Smart Phone Usage Patterns among Older Adults .............................................. Guidance on Smart Phone Design for Seniors ..................................................... Use of Technology and Smart Phones in Saudi Arabia ...................................... Chapter Summary ............................................................................................. 8 9 11 18 21 26 28 34 36 CHAPTER 3 METHODS .................................................................................... 37 Participants and Recruitment .............................................................................. Data Collection ................................................................................................... Data Analysis and Interpretation ...................................................................... 38 40 44 CHAPTER 4 SURVEY RESULTS ..................................................................... 46 Characteristics of Participants.............................................................................. Attitudes to Technology....................................................................................... Smart Phone Usage ............................................................................................. Ease of Use ....................................................................................................... Non Users of Smart Phones ................................................................................ Chapter Summary ............................................................................................... 47 50 55 61 67 74 CHAPTER 5 PROTOTYPE APPLICATION EVALUATION RESULTS ........ 75 Design of the Prototype Application.................................................................... Structure and Content of the Prototype Application ............................................ 77 78 iii Recruitment and Participants ............................................................................... Evaluation Results .............................................................................................. Chapter Summary ............................................................................................... CHAPTER 6 83 84 94 QUALITATIVE INTERVIEW FINDINGS ................................... 96 Smart Phone Use among Saudi Arabian Seniors ................................................. Lack of Confidence or Experience in Using Technology ................................... Practical Difficulties in Using Smart Phones ...................................................... Language Related Influences on Use of Smart Phones ....................................... Cultural Influences on Use of Smart Phones ....................................................... Encouraging other Seniors to Use Smart Phones ................................................ Chapter Summary ................................................................................................ 97 100 104 106 107 112 114 CHAPTER 7 SUMMARY, RECOMMENDATIONS AND CONCLUSIONS .. 116 Summary of Survey Findings ............................................................................. Summary of Prototype Evaluation Findings ........................................................ Interview Findings and Discussion ...................................................................... Contribution of the Study .................................................................................... Practical recommendations .................................................................................. Recommendations for Future Research and Theory Development ..................... Limitations of the Study ...................................................................................... Conclusion .......................................................................................................... 117 117 118 122 127 128 131 132 REFERENCES .......................................................................................................... 134 APPENDIX A - SURVEY QUESTIONNAIRE ...................................................... 143 APPENDIX B - PROTOTYPE EVALUATION QUESTIONS ............................... 149 APPENDIX C - IN-DEPTH INTERVIEW QUESTION GUIDE ............................ 152 APPENDIX D - IRB APPROVALS ......................................................................... 158 iv ACKNOWLEDGMENTS I would like to thank my committee chair, James H Oliver, and my committee members, Richard T Stone, Sunghyun Ryoo Kang, Jonathan Kelly, and Doug W Jacobson, for their guidance and support throughout the course of this research. In addition, I would also like to thank my parents, my wife, my friends and my siblings for their unfailing support during my studies, and my colleagues, the department faculty and staff for making my time at Iowa State University a wonderful experience. I want to also offer my appreciation to those who were willing to participate in my research, without whom, this thesis would not have been possible. Finally, I would like to express my gratitude to the Government of Saudi Arabia for sponsoring me to conduct my studies in the United States. v ABSTRACT This empirical study investigates attitudes about smart phones and their use by senior citizens in the Kingdom of Saudi Arabia (KSA), and develops general design guidelines for a smart phone interface designed to appeal to this group and thus increase the adoption of smart phones among its members. The overall rationale for the study is to enable seniors in Arabic-speaking, predominantly Muslim countries to better access the proven benefits of smart phone use among seniors, including positive impacts on mental functioning, the adoption of healthier lifestyles through improved access to healthcare information and applications, and to support more autonomous and independent living. Many studies have generated best practice guidance on smart phone design for seniors, but these have mostly been conducted in Western, English-speaking countries. This research builds on existing best practice guidance but uses the study findings to prioritize the most important design points relating to the needs of Arabic-speaking users in Muslim countries, and to identify any required additions or modifications to the existing guidance and to current theories of technology adoption. The initial findings of a survey of Saudi Arabian senior citizens were used to develop a prototype smart phone interface, which was evaluated by a sample of participants. The outcomes of this trial and the findings of semi-structured interviews were then used to develop final recommendations for a smart phone application for use by the target population, and for a modified theory of technology adoption. 1 CHAPTER 1. INTRODUCTION Studies conducted internationally have indicated that a high proportion of older people are not users of digital technology, and that many seniors face barriers such as a lack of confidence in using technology or physical conditions that make it difficult for them to use smart phones or other digital devices (e.g., Pew Center, 2014). A number of studies have generated best practice guidance on the design of smart phone interfaces for use by senior citizens. However, most smart phone interfaces are designed primarily for use by Western, English-speaking populations, and similarly, the best practice guidance on smart phone design for seniors has also mainly been developed based on research conducted in the West. Little previous research has been conducted into older people’s use of smart phones in Arabic-speaking, predominantly Muslim countries, where seniors may face additional cultural and language-related difficulties in their use. In Saudi Arabia, the setting for the proposed study, research with younger adults has confirmed the need to modify smart phone interfaces to the local culture and language. For example, Aldhaban, Daim and Harmon (2015) explored the impact of the Saudi Arabian cultural and social context on the use of smart phones in this environment. The intention of the authors was to develop a new theoretical model for use in Arabic settings based on the Unified Theory of Acceptance and Use of Technology (UTAUT) (Venkatesh et al., 2003). The study revealed in particular the role of language as a factor influencing take up of smart phones in Saudi Arabia, since smartest phone interfaces and content are designed primarily for English-speaking users. Al-Mouh & Al-Khalifa (2015) investigated the use of smart phones among a sample of Arabic-speaking visually impaired people in Saudi Arabia. They 2 found that 83% of participants were using an Arabic user interface and 91% were using touch screen phones due to the availability of Arabic support and the advanced features available on these phones. The vast majority were using iPhones because the screen reader of these phones supports Arabic. This indicates that guidance on best practice smart phone design for seniors cannot be directly adopted for use by Arabic-speaking, Muslim seniors in Saudi Arabia and may need to be tailored to the specific needs of this population. Currently, an information gap exists in relation to the specific needs and requirements of Saudi seniors for a smart phone interface design. The proposed study is intended to fill this gap by conducting empirical research with this group and developing recommendations for a smart phone interface that will appeal to senior citizens in Saudi Arabia, as an example of an older Arabic-speaking, Muslim population. This is expected to increase the adoption of smart phones among this group, enabling them to better access the benefits of mobile technology that are well documented in the literature. Technology and Older People According to the United Nations World Population Ageing Report (2015), nearly every country worldwide is experiencing an increase in the number and proportion of older people in their population. In view of these demographic changes and growing numbers of seniors in most populations, there has been growing interest in the ways in which new technologies, such as smart phones, can be used by and provide potential benefits for this group. Researchers have found evidence of a positive relationship between the use of technology and general levels of well-being among older people (Mitzner et al., 2010), and 3 studies are revealing many ways in which smart phones and other computing devices are helping to prevent cognitive, sensory and motor decline among seniors, and enhancing their independence and daily functioning (Charness & Boot, 2009; Czaja et al., 2006; RamonJeronimo, Peral-Peral, & Arenas-Gaitan, 2013). Smart phones have been defined as “a hand-held computer capable of multiple functions in addition to placing calls” (Kaplan, 2012, p.129). Despite the considerable potential of smart phones and other Information and Communication Technology devices such as laptops and desktop computers for improving quality of life among seniors, there are various barriers to their use by this group. This is reflected in low levels of ownership and limited use of available smart phone functions. Anderson (2015) reports that in the United States only 30% of adults aged 65 or over own smart phones compared with more than 80% of adults aged between 18 and 49. Researchers have documented a range of physical, cognitive and psychological difficulties often experienced by senior citizens when using smart phones. These include for example, physical and health challenges, decreases in cognitive abilities and in memory, declining visual and auditory abilities, and a lack of confidence in dealing with new technology, as discussed in the literature review presented in Chapter 2. Guidance on Smart Phone Interface Design for Senior Citizens A substantial body of literature in this area contains practical research-based guidance and recommendations on developing smart phone interfaces and other forms of technology for use by older people (e.g. Hawthorn, 2000; Strengers, 2012). This literature is based on a range of methods including systematic reviews and empirical research with older adults. Fisk 4 et al. (2009) highlight the importance of taking into account changes in perceptual, cognitive and motors systems when designing any form of technology for older people. Based on their focus groups with seniors, they found that 47% of the difficulties that older people face when using technology is related to financial, health related or other general concerns. Of the remainder, they concluded that 25% can be remedied by improved design of systems, and that the rest can potentially be resolved by training or a combination of training and design modifications. This suggests that improved design of smart phone interfaces to meet the needs of seniors is likely to help change attitudes towards smart phone use among this group and increase adoption. Based on a review of the literature in this area, the main recommendations for best practice smart phone interface design for seniors are summarized in Chapter 2. Smart Phone Use in Saudi Arabia No previous research has examined the use of smart phones or other new technologies among seniors in Saudi Arabia. However, a small number of studies have examined technology adoption and smart phone usage among younger people in Saudi Arabia and among Arabic-speaking users in the West, and have highlighted the need to adapt smart phone interface design to the needs of these groups, as discussed in Chapter 2. Theoretical Framework A number of theories have been developed to explain the adoption of technologies, which can be used to help inform the design of smart phones for use by older adults, and to structure research in this area. The most widely used is the Technology Acceptance Model 5 (TAM) (Davis, 1989), which was developed as a theoretical explanation of the factors influencing the adoption of technology, and built on earlier theories of technology adoption (Fishbein & Ajzen, 1975; 1980; Ajzen, 1991) which proposed that an individual’s behavior in general is driven by his or her intention to perform an action, which in turn reflects the subjective norms of their society and their own attitude towards performing the behavior. The TAM applied the conceptual framework of these earlier models to the specific context of technology adoption, and identified two main attitudinal influences on technology adoption: perceived usefulness (PU), and perceived ease of use (PEOU). This is discussed in more detail in Chapter 2, along with other theories of technology adoption, and forms the theoretical framework for the study. Purpose of Study and Research Questions The purpose of the study is to investigate attitudes about smart phones and their use by senior citizens in Saudi Arabia, to identify the functionalities and features needed to promote the more rapid adoption of smart phones among the population of Arabic-speaking, Muslim seniors in Middle Eastern countries. The study builds on the existing published guidance on smart phone design for seniors, but prioritizes the most important design points corresponding to the needs of Arab-speaking users in the cultural setting of Saudi Arabia, and identifies ways in which the existing guidance needs to be modified to meet these needs. The initial findings of a survey of Saudi Arabian senior citizens regarding the use of smart phones are used to develop and trial a prototype religious smart phone application, with the outcomes of this trial as well as the survey findings being used to develop recommendations for a smart phone application designed for use by senior citizens in Saudi Arabia. A third 6 stage of research is intended to generate further insights into the influence of cultural and language on attitudes to and the use of smart phones among this group, through the use of qualitative interviews with a smaller sample of Saudi Arabian seniors, and to evaluate the applicability of existing theories of technology adoption to this population. In these ways, the study is expected to make a significant contribution to the existing literature relating to the design of smart phone design for seniors, particularly by taking into account the influence of factors such as culture, religion and language. The study addresses the following research questions: 1. What are the characteristics of smart phone usage among senior citizens in Saudi Arabia? 2. What types of difficulties do senior citizens in Saudi Arabia experience when using smart phones? 3. How effective are existing theories of technology adoption for explaining attitudes to and use of smart phones among older a...
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