Technology Affordance in an Information and Communication Technology Delivered Group Psychotherapy and Exercise Program for Older People With Depressive Symptoms: A Multiple Triangulation Qualitative Study

Dara Kiu Yi LEUNG, Frankie Ho Chun WONG, Edwin Lok Yan WONG, Lesley SZE, Melissa CHAN, Tianyin LIU, Annabelle Pui Chi FONG, Wai Wai KWOK, Angie Kwan Yu SHUM, Gloria Hoi Yan WONG, Terry Yat Sang LUM*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

2 Citations (Scopus)

Abstract

Background and Objectives: Health and mental health interventions, such as psychotherapy and exercise programs, delivered via information and communication technology (ICT) may improve service access. However, adjustment among older people and in synchronous group interventions is more challenging. Technology affordance concerns the possibilities engendered by technology for various users and purposes and can help understand challenges in ICT-delivered groups and identify possible solutions. Research Design and Methods: Adopting a multiple triangulation approach, we observed ICT-delivered groups of acceptance and commitment therapy and exercise for older people with depressive symptoms, conducted focus groups with older people who had received group psychotherapy with or without an exercise component, and obtained clinical notes from interventionists. We conducted a thematic analysis of the observation notes, focus group transcriptions, and clinical notes. Results: Four focus groups were conducted with 22 participants (mean age = 72.6 years, standard deviation = 7.2, 86% female). We identified 3 challenges: (1) seeing–be seen dilemma, (2) speaking–hearing dilemma, and (3) blurred therapy–home boundary, and 2 solutions: (1) maneuvering layouts and collaborative tools, and (2) cross-platform mediated strategies. Participants struggled to observe the interventionist while simultaneously demonstrating their posture in front of a camera. Remaining silent and moderated turn-taking allowed for clearer hearing but limited interactions. Interruptions from the background environment and intersections of family living spaces disrupted audio-visual communication and jeopardized the sense of security. As a solution, interventionists maneuvered layouts and collaborative tools on teleconferencing applications to achieve intervention goals and provided support through different media. Discussion and Implications: The identified challenges and potential solutions can be understood from interactivity, portability, temporality, persistence, and multimediality. Technology affordance can guide ICT-delivered group design by matching the affordance of various technologies and communication media with the characteristics of the intervention and users to enhance efficacy and avoid an unnecessary digital divide.

Original languageEnglish
Article numberigad063
Number of pages10
JournalInnovation in Aging
Volume7
Issue number6
Early online date7 Jul 2023
DOIs
Publication statusPublished - 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Funding

This work is supported by the Hong Kong Jockey Club Charities Trust for The University of Hong Kong for the Project JC JoyAge: Jockey Club Holistic Support Project for Elderly Mental Wellness (HKU Project Codes: AR160026, AR190017). The funder has no role in the preparation of data or the manuscript.

Keywords

  • Chronic pain
  • Cross-platform
  • Telehealth
  • Telemental health
  • Teletherapy

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