GOAL: An eHealth Application for Rewarding Healthy Behaviour.

The First Experiences of Older Adults

Stephanie Jansen Kosterink

1,2

, Roos Bulthuis

1,2

, Silke ter Stal

1,2

, Aristodemos Pnevmatikakis

Sofoklis Kyriazakos

, Andrew Pomazanskyi

and Harm op den Akker

1,2

Cluster Telemedicine, Roessingh Research and Development, Enschede, The Netherlands

Telemedicine Group, University of Twente, Enschede, The Netherlands

Multimodal Signal Analytics, Athens Information Technology, Athens, Greece

Department of Business Development and Technology, Aarhus University, Aarhus, Denmark

Nurogames GmbH, Cologne, Germany

andrew.pomazanskyi@nurogames.com

Keywords: Older Adults, eHealth, mHealth, Games, Rewards, Evaluation.

Abstract: It is important to motivate older adults to lead an active lifestyle. Mobile games and applications can motivate

older adults to increase physical, social and cognitive activity. Such a mobile application platform is

developed within the GOAL project (H2020 project no. 731656). The aim of this paper is to introduce GOAL,

to provide an overview of ongoing evaluations and to present the intermediate results concerning the usability

of end-user acceptance of this technology among older adults. GOAL consists of three core components: the

GOAL Website, the GOAL Web Portal and the GOAL Mobile Applications. The evaluation has an iterative

approach. In total, there are four evaluation phases. During the first three phases, subjects are invited for a

pre-test and post-test assessment. During phase 4, subjects are invited to use GOAL by sending out a mass

email to get people to sign up to GOAL for themselves. The results of phase 1, 2 and 3 of the evaluation

(especially the suggestions by the target group) lead to several points of improvement for the GOAL system,

to increase the adoption of this technology by older adults. Over the phases, the level of usability increased

and subjects become more and more enthusiastic about GOAL.

1 INTRODUCTION

In the European Union, demographic ageing is a

trend. The number of people aged 65+ will almost

double over the next 50 years, from 85 million in

2008 to 151 million in 2060 (World Health

Organization, 2015). With aging, occurrence of

multi-morbidity and the need of social and health

support increases as well. Ageing is a dynamic

process and there is great diversity in how older adults

age (Buckinx et al., 2015, Suzman et al., 2015).

However, preventive strategies are important to face

the challenge of age- and health- related problems. An

effective strategy for healthy ageing is to be

physically active (Zaleski et al., 2016). Being

physically active has many benefits: it prevents the

development of chronic health-related problems, it

improves psychological well-being and social

outcomes (Bauman et al., 2016), and can slow down

muscle loss and prevent a decrease in strength

(Mijnarends et al., 2013, Tak et al., 2013, Zaleski et

al., 2016). Despite the benefits of being physically

active, the overwhelming majority of older adults do

not meet the minimum physical activity levels needed

to maintain health (McPhee et al., 2016).

Unfortunately, a sedentary lifestyle is currently

predominant in European older adults. Among older

adults, inactivity and a sedentary lifestyle are linked

to numerous negative health outcomes, comparable to

the negative health outcomes of smoking, excessive

alcohol intake and obesity (Booth et al., 2000, Lee et

al., 2012). It is thus important to motivate older adults

to be physically active.

However, it is a challenge to find effective ways

to support older adults to increase their level of

physical activity and develop habitual physical

activity behaviours. It is known that older adults are

less interested in improving their health, but more

interested in retaining the health they already possess

(Lockenhoff and Carstensen, 2004). Moreover, they

Kosterink, S., Bulthuis, R., ter Stal, S., Pnevmatikakis, A., Kyriazakos, S., Pomazanskyi, A. and Akker, H.

GOAL: An eHealth Application for Rewarding Healthy Behaviour. The First Experiences of Older Adults.

DOI: 10.5220/0007680900580066

In Proceedings of the 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2019), pages 58-66

ISBN: 978-989-758-368-1

are more interested in intrinsically enjoyable

activities, such as group activities (Devereux-

Fitzgerald et al., 2016), as they emphasise fun and

enjoyment of social interaction as a motivation to be

physically active.

The engaging nature of games can also provide a

motivating and enjoyable means to comply to

exercises and to increase physical activity (Taylor et

al., 2011, Kato, 2010). Games can be provided to

older adults in the old-fashioned way, such as board

games but also as a mobile application for their

smartphone or tablet as the use of these technologies

for health-related purposes is rapidly increasing

(Gordon and Hornbrook, 2018). Next to this,

gamification (the application of game elements to

nongame field) engages older adults to use, and keep

using technology (Minge et al., 2014, de Vette et al.,

2015).

A new mobile application to motivate older adults

to be active is developed in the GOAL project (H2020

project no. 731656). Within this project a mobile

application rewards healthy behaviour, such as being

physically active, training the memory and

participating in social activities, with GOAL coins.

These coins can be used in mobile games. In the

future, these coins are also tradable for tangible

rewards. As the adoption of technology remains

limited in the older population (Heart and Kalderon,

2013, Mitzner et al., 2019), during the development

of GOAL the target population is asked to use GOAL

and share their experiences. To increase the adoption

of GOAL, the expectations and needs of the older

adults are used to improve GOAL before its

introduction to the market. The aims of this paper are

to introduce GOAL, to provide an overview of the

current evaluation, and to present the intermediate

results concerning the usability and end-user

acceptance of this technology.

2 METHODS

From the point of view of the end-user, GOAL

consists of the three core components: the GOAL

Website, the GOAL Web Portal and the GOAL

Mobile Applications. The Website is the “entry-

point” to the platform. This website leads the end-user

to a signup page for new users. Within the Web Portal

the end-user is able to set up an account or log in into

the portal using already existing credentials. Upon

registration or login, the user is exposed to the main

dashboard of the web application from which they are

able to navigate to the main sections of the application

including the Wallet (providing an overview of

GOAL coin transactions), the Physical activity

dashboard, Games and access to a Social

Marketplace. The GOAL Mobile Application is the

information centre the user utilizes to get all GOAL-

related info and access the different GOAL services.

It offers users’ profile management, GOAL coins’

information, games’ information and access, tasks

management and uniquely for the mobile version,

physical activity tracking. The information is

summarized in an overview screen, from where the

user can navigate to details screens for physical

activity, GOAL coins, games and social marketplace

tasks (see figure 1).

Figure 1: Overview screen of the GOAL Mobile

Application.

The GOAL Mobile Application measures and

displays physical activity in terms of steps, floors

climbed, energy burned and minutes spent at different

activity intensities. Both instantaneous values

GOAL: An eHealth Application for Rewarding Healthy Behaviour. The First Experiences of Older Adults

(together with a clear view of the percentage of the

goals reached in all activity categories) and plots of

past data are offered, in an attempt to inform and

motivate the user. The GOAL coin is the single

currency quantifying performance in different aspects

of the users’ daily life. Coins are earned when goals

are met, or tasks are fulfilled. Coins can be spent in

an attempt to motivate others via tasks, or in games.

The coins’ overview screen shows the current number

of coins, the number of coins earned or spent in

different intervals and a list of every coin transaction

in those different intervals, together with an

explanation and a date. Games are important both for

cognitive stimulus and for entertainment. The games

overview screen shows all games and scores played

thus far, as well as a list of the GOAL games, either

already installed, or available on Google Play. The

GOAL Mobile Application is also the home of the

GOAL Motivational Agent. From every screen of the

GOAL Mobile Application, the motivational agent

can be reached with a simple tap of the “Agent”

button. Whenever the user calls for the agent, he/she

can have simple interactive dialogues with this agent.

The social marketplace functionality is accessed via

the tasks overview screen. The offered functionality

is split into two categories: tasks the user creates, and

the tasks the user undertakes. For task creation, the

user is given an overview of the tasks he/she has

created and a form to create more. For tasks

undertaking, the user gets an overview of the tasks in

which he or she participates, the remaining duration,

and when applicable, the progress made.

The “Island Exploration Game” (Figure 2) is a

gamification layer on top of the physical activity data

measured from the user. The user needs to complete

a path through a tropical island by performing

physical activity. The user has a week to finish the

path. The path is cut into seven pieces, all with a

milestone at the end. The amount of steps needed to

get to a milestone is equal to the user’s personal daily

step goal. When a milestone is reached, the user can

play a mini-game. When a “hut” on the island is

unlocked, the user can enter it to play a puzzle game

to earn the hut’s rewards. The mini-game is a ‘24

game’. The user drags numbers and operators into the

correct boxes, to make the expression equal 24.

Successfully completing these mini-games will grant

the user with additional GOAL Coins.

Figure 2: Screen of the Island Exploration Game.

GOAL supports the integration from “3

party”

health applications. From the product perspective,

commercial health apps such as Fitbit, Nokia Health

or Samsung Health could integrate their applications

with the GOAL platform and report user’s health and

wellbeing data to the platform. In this way, users can

continue using their preferred fitness tracker, food

logging app, weight manager or relaxation app while

benefitting from the additional motivation to use

those apps through the GOAL platform. During the

evaluation period, five “3rd party” applications are

available; the “Activity Coach” app for Android,

developed by Roessingh Research and Development

that interfaces Fitbit step data into GOAL and the

following games:

 PairMe! is a cognitive game developed by Athens

Information Technology, addressing memory

functions. It is a card-based game, where a deck is

arranged in a grid and the player attempts to turn

two cards depicting the same image. The user can

spend his GOAL coins to unlock new card themes

or shortly glimpse at the remaining cards.

ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health

 Let’s quiz is trivia game developed by Nurogames

to test user’s cognitive abilities by giving them a

set of questions from various knowledge areas

with a multiple choice to find the correct answer

within a given timeframe. The user can spend

GOAL coins to reduce the number of possible

multiple-choice answers, making it easier.

 World of Kingdoms is a role-playing game

developed by Nurogames for Android and iOS

devices. The game brings a beautifully designed

world where players have to build their villages

and kingdoms along with defence structures and

armies, plan the respective strategies to protect

themselves as well as gain gold to improve their

village. Using the GOAL credentials will transfer

the available GOAL Coins to the World of

Kingdoms account.

 The “Forward To” game is designed as a health-

promoting application within the H2020

SmartLife project that puts emphasis on a story

that takes place in a post-apocalyptic world and

can be played indoors and outside with a focus on

mini challenges that require physical activities

that are tracked by a smart textile the player has to

wear.

2.1 Participants

For the iterative evaluation process, a phased

introduction of the GOAL platform is desirable and

the involvement of real end-users is also very

important. Before real end-users are involved, GOAL

is tested by end-users close to the research &

development setting, mostly younger end-users as

students. The target population for GOAL is older

adults with the desire to stay active and to change

their behaviour in a positive way. For phase 1 and 2,

students and colleagues are asked to participate. For

phase 3 and 4, older adults are asked to use GOAL.

According to Dutch law, the nature of the research

(usability and user-experience) in this study does not

require formal ethical approval. However, all

participants gave their informed consent prior to

participation.

2.2 Setting

The total duration of this observational study is 28

weeks. To facilitate improvement of GOAL and its

uptake by users, an iterative approach is followed

(van Velsen et al., 2018). Therefore, during this study,

the GOAL platform and technology will be updated

and improved based on the outcomes of the

evaluation. In total, four versions of the GOAL

platform are evaluated during four phases of the

evaluation. Every phase contains test-weeks and

weeks for analysis and technical modification. The

duration for phase 1 and 2 is 6 weeks. During these

phases, subjects are invited for a pre-test and post-test

assessment. After a short introduction subject are

asked during the pre-test assessment to performed

four basic task: installation of the GOAL application

(1), account creation and set-up (2), visiting the

GOAL web portal (3) and installation of additional

GOAL apps (4). During the post-test assessment the

first experiences with the platform are discussed as

well as the advantages and points for improvement.

Between pre- and post-test is a period of 7 days.

During phase 3, the set-up of the pre- and post-test

assessments is the same, only the time between the

two appointments is 2 weeks. During the first 3

phases GOAL is evaluated in a controlled setting;

individuals are invited to participate, subjects receive

assistance by installing GOAL and subjects are to use

GOAL for a certain amount of time. After phase 3,

the maturity of GOAL should be sufficient for large-

scale implementation. Therefore, during phase 4,

subjects are invited to use GOAL by sending out a

mass email to get people to sign up to GOAL for

themselves. After installation and registration on the

GOAL platform, these people are asked by email

whether he/she is willing to participate in research

and complete the online questionnaire after the test-

weeks.

2.3 Measurements

Considering the maturity of the technology and the

aim of the technology, this first evaluation of GOAL

focus on the endpoints: Usability and end-user

acceptance (DeChant et al., 1996, Jansen-Kosterink

et al., 2016). Pre- and post-test participants are asked

to complete questionnaires concerning usability and

end-user acceptance. Moreover, subjects are asked

about problems encountered during use, and

observations during task execution are written down.

2.3.1 Usability

The usability of GOAL is assessed with the System

Usability Scale (Brooke, 1995). The SUS presents ten

statements about the perceived usability of the

application. Participants could indicate on a 0 to 4

scale to what extent the presented statements were

true for them. To obtain the final SUS score, the sum

of the participants’ answers was multiplied by 2.5.

The SUS score ranges from 0 to 100 (low and high

usability, respectively). The English version of the

GOAL: An eHealth Application for Rewarding Healthy Behaviour. The First Experiences of Older Adults

SUS was translated into Dutch, as there was no

validated Dutch version available.

2.3.2 End-user Acceptance

End-user acceptance of GOAL is assessed by means

of a questionnaire with summated rating scales, based

upon the Technology Acceptance Model (TAM)

(Davis, 1989). TAM originates from the 1980s and

has been used numerous times to assess and explain

the acceptance of new technology. We expanded

TAM with factors that have been found to shape the

user experience of eHealth technology: Enjoyment

(Crutzen et al., 2011), Aesthetics (Baumel and

Muench, 2016), Control (Hawkins et al., 2010), and

Trust in the technology (Van Velsen et al., 2016). We

hypothesize that these factors affect the core factors

of TAM that explain the intention to use (perceived

usefulness and ease of use).

2.4 Data Analysis

All outcome measures will be inspected for normal

distribution of data using corresponding histogram

plots including normal curves and normal probability

plots prior to selection of appropriate statistical tests.

Descriptive statistical methods will be applied for

each of the outcome measures (demographic

characteristics, usability, end-user and acceptance).

Presentation of data will be done by calculation of

mean ± standard deviation, or median with range.

3 RESULTS

The evaluation of GOAL started in the first week of

September 2018 and is still ongoing. Phase 1 through

3 have ended, while phase 4 has not started yet.

Therefore, only the results of phase 1, 2 and 3 are

presented.

3.1 Phase 1

During the first phase, the base version of GOAL was

used. This version includes the GOAL mobile

application that can be paired with the Activity

Coach. In total five participants completed the first

phase of the GOAL evaluation. Of the subject, four

were female and one was male. Their age was

between 23 and 26 years old; all were students and

worked on a bachelor or master assignment or

working as junior researcher at Roessingh Research

and Development. Five subjects completed the pre-

test and four subjects completed the post-test of phase

1. Pre-test the SUS score was between 28 and 75

points (n=5). The opinion of the participants was

diverse, some were enthusiastic and some were very

critical. The average score on the SUS was 55 (SD

20.2) indicating that the usability is “ok”, but also has

a low acceptability range. Post-test the SUS score

changed, the participants rate the GOAL application

between 43 and 68 and an average score of 56 (SD

10.5, n=4). The scores on the end-user acceptance

were very diverse. Overall, their opinion on the end-

user acceptance was ambiguous.

Pre-test the subjects had problems with the

executing the four basic tasks. Subjects had problems

with finding the GOAL application in the Google

Play store. After registration, the application did not

provide any feedback on whether the registration was

successful. Subjects also indicated that they were

unaware of the term “stride length”. Overall, subjects

thought the setting to update their profile were

intuitive, although it was unclear how profile details

were saved. When going to the web portal,

participants noticed that it was not optimized for use

on the mobile phone, although they indicated they

would like to use the website on their phone. They

would find it convenient to have a link to the website

in the app, but it all cases be referred to the app when

they are linked to the ‘GOAL Platform’ from an

external application.

Post-test the subjects liked the potential to get a

reward for being active. The interface of the app was

easy and intuitive, despite many options being

available. However, the subjects indicated that none

of the options were functional. The step counter did

not work, it was unclear if they needed an external

activity monitor to count steps, the participants could

not collect any coins or set goals/tasks, and the games

were not available yet.

3.2 Phase 2

During the second phase, the base version of GOAL

was enhanced in terms of visualisation of

information, user profile collection and a help system.

Two new games could be downloaded from the

Google Play store: ‘Let’s Quiz!’ and ‘Pair Me!’. In

total nine participants completed the second phase of

the GOAL evaluation. Four of them also participated

in the first phase. Of the participants, six were female

and three were male. Their age was between 23 and

27 years old and all were students working on a

bachelor or master assignment, or working as junior

researcher at Roessingh Research and Development.

Five participants completed both the pre- and post-

test. Four participants, who participated in phase 1 as

ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health

well, only completed the post-test. Pre-test the SUS

score was between 40 and 85 points (n=5). The

opinion of the subjects was diverse, some were

enthusiastic and some were very critical. The average

score on the SUS was 61.5 (SD 21.8) indicating that

the usability is “ok”, but also has a low acceptability

range. Post-test the SUS score changes, the subjects

rate GOAL between 32 and 80, with an average score

of 58.2 (SD 12.8, n=9). The scores on the end-user

acceptance were very diverse. Overall, their opinion

on the user experience determinants was ambiguous.

At pre-test, the subjects (n=5) had problems with

executing the four basic tasks. Participants still had

problems with finding the GOAL application in the

Google Play store. Setting-up the account was very

intuitive, and participants found the explaining texts

about stride length and other entries useful. However,

participants still indicated that it was unclear whether

and how they could save the entered profile details

(n=4). The participants viewed the website on a

laptop and found the design nice and clean, with clear

headings (n=4 and n=3 respectively). Participants

liked that they could find the games in the GOAL app

(n=5), although they would like to receive a

confirmation that they successfully connected the

game to the GOAL app (n=3). It was suggested to

integrate the games into one app package with the

GOAL app, so no separate downloads would be

necessary.

Nine subjects participated in the post-test of phase

2. During this post-test session various advantages,

improvements and problems were discussed. The app

was already improved compared to the first phase.

Two games were now available to play and people

enjoyed the way their activity level was represented;

the graphs were informative and it was nice to have

different representations of activity level. However,

participants did not collect any coins nor understood

how they could collect coins (n=7). Moreover, despite

being able to set tasks, it was hard to understand what

could be done with them (n=6). Some participants

mentioned that the step counter did not work at all,

others thought it only worked when opening the app,

and a few stated that the step counter was not

accurate. ‘Let’s Quiz!’ appeared to have some bugs;

questions were repeated, too hard, or contained

mistakes (n=4). Four participants, who had already

participated in phase 1, mentioned that they forgot

their password and would like a ‘password reset’

button.

3.3 Phase 3

During the third phase, the base version of GOAL

with several updates was used. The app now supports

the external activity tracker ‘Activity Coach’, and

coins are awarded for reaching activity goals. Users

can setup tasks or participate to them. Past activities

are now summarized. Moreover, some technical

problems with the step counter and ‘Let’s Quiz!’ were

solved. By email, 104 older adults were asked to

participate in this study. Fifteen were willing to

participate. However, five subjects were not able to

participate as two of them did not have a smartphone

and three of them did not have a smartphone with an

android operating system. Furthermore, two subjects

were not able to participate due to motivation issues

or health compliances. In total seven subjects

participated in the pre-test of the third phase of the

GOAL evaluation. One subject did not participate in

the pre-test, but has downloaded the app at home and

was included in the post-test. Of the subjects, two

were female and six were male. Their age was

between 69 and 76 years old. Pre-test the GOAL SUS

score was between 55 and 80 points (n=7). The

average score on the SUS was 70 (SD 8.5), indicating

that the usability is “ok”, with a high acceptability

range. Post-test, the SUS score decreased, the eight

participants rated the GOAL application between 40

and 87.5, with an average score of 65.6 (SD 15.7,

n=8). This is slightly lower than pre-test although still

with a high marginal acceptability range. The scores

on the end-user acceptance were very diverse.

Notable was the high score of five participants on

“intention to use”. Overall, their opinion on the user

experience determinants was ambiguous.

At pre-test, the subjects (n=7) had problems with

executing the four basic tasks. Three subjects

indicated they had never used the play store before;

one had problems with downloading the app. All

managed to download and install the GOAL

application (n=7). Registering required additional

instructions, typing the password twice was

problematic to some, because they could not see the

letters (n=3). All subjects needed instructions to set-

up profile, and some with entering the details such as

name and date of birth (n=4). Some technical

problems were also encountered (n=5). When going

to the GOAL website on a laptop, four subjects had

no problem finding the log-in page, but many

indicated that the log-in page and dashboard were

hard to read due to the low contrast of letters (n=5).

The dashboard was perceived logical and simple

(n=4), although questions were asked about the

‘applications’ and ‘social marketplace’ blocks (n=4).

GOAL: An eHealth Application for Rewarding Healthy Behaviour. The First Experiences of Older Adults

Some explanation about altitude, MET-minutes, and

the other physical activity graphs was needed. All

completed the last task (installing the “PairMe!”

game) although instructions about finding it in

Google Play Store were needed. Some did not like the

keyboard falling over the log-in screen when

connecting to “PairMe!” (n=4), although almost

everyone managed to connect the app to the GOAL

platform (n=6).

Eight subjects participated in the post-test of

phase 3. Post-test, five subjects indicated that the step

counter did not work and did not count steps at all.

Two participants indicated that they do not carry their

phone all the time and one would prefer to have a

wrist-worn step counter. Some participants did not

understand MET minutes (n=3) or the red line in the

activity graph (n=1), and two preferred more

explanations about the menu and functions of the app

(n=2). Three subjects indicated they would like to

record cycling as well, and a Dutch app version is

preferred (n=3). Half of the subjects enjoyed the

games (n=4), and three subjects indicated they would

like to use the app if it would actually count steps

accurately. The dashboard was perceived as simple

and basic, with a nice overview of everything (n=3).

The subjects did not specifically like collecting coins;

many did not collect coins at all, as their step counter

did not work. None of them used coins in the games.

Two subjects forgot their password and could not use

the memory game.

3.3.1 Focus Groups

During phase 3 of the GOAL evaluation, we got the

opportunity by means of two focus groups to assess

the GOAL technology among a group of older adults

of a local elderly association. These focus groups

were planned on December 18, 2018. After an

introduction of the GOAL technology, the older

adults were asked to share with us their perceived

advantages and disadvantages and their ideas

concerning the concept of earning GOAL coins. In

total 21 older adults participated during the two focus

groups. The majority of the participants were male

(62%). The average age of participants was 72 years

old (SD±3.7 years; range 64 – 79 year old). As

perceived advantage, the majority of the participants

(52%) mentioned the aim of the technology to

encourage a healthy lifestyle. Next to this, 33% of the

participants claimed that the fact that the GOAL

technology is free to use (no financial reimbursement)

is an advantage. Also 24% mentioned that they liked

the idea of learning something new and experiencing

the GOAL technology as fun or a nice challenge. As

a disadvantage, participants mentioned the fact that

the GOAL mobile application is only available for

Android smartphones (43%) and that the GOAL

mobile application is mainly in English (24%).

Another disadvantage that was mentioned was the

reluctance to playing mobile games (24%) by the

target population. Most participants (62%) claimed

that maintaining health was the biggest reward when

using the GOAL technology. Another reward

mentioned was “making progression visual”, this was

mentioned by 33% of the participants. Next to this,

19% of the participants experienced being active in

nature as a reward. Considering earning GOAL coins,

the most of the participants (38%) claimed that they

want to earn GOAL coins by being physically active.

Finally, the participants were asked how they would

like to spend the earned GOAL coins in the real

world. Nine participants would like to receive a gift

card for (digital) books / newspapers (n=3) or for

things related to their hobby (n=5) or to buy new

technology (n=1). Four participants would like to

help others or charity, one participant would like to

spend coins on activity with their grandchildren and

one participant would like to receive a discount on

their health insurance. Overall, 38% of the participant

had no interest in spending earned GOAL coins in the

real world.

4 CONCLUSIONS

The evaluation of the GOAL system is still running.

The results of phase 1, 2 and 3 of the evaluation lead

to several improvements of GOAL, facilitating the

adoption of this technology by older adults. Over the

phases, the level of usability increased and subjects

become more and more enthusiastic about GOAL.

However, the following recommendations based on

the usability and user-acceptation of GOAL can be

made:

 There should be a password reset button, in case

one forgets the password;

 The app should have an help-function explaining

for instance how coins can be collected and the

concept of MET.

 The profile section can be more simplistic with a

clear button to save entered details;

 The website should have a higher contrast so it

will be more accessible for people with impaired

vision;

 The activity tracker should also recognize other

activities than walking, such as cycling;

ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health

 The app should be available in the local

languages.

During the third evaluation phase, older adults needed

instructions to download and install the app, to set-up

the profile, to go to the website, and to connect to a

game. The external help that is requested by the older

adults will be provided by a motivational agent

(Bickmore et al., 2009, Vardoulakis et al., 2012). This

motivational agent is planned for the next version of

GOAL. This feature of the Mobile application can

increase the level of intuition and provide the needed

instructions to the older adults, so external help is not

necessary anymore. Moreover, the functionality of

the social marketplace task-setting and activity

tracking, and technical problems will be addressed in

the phase 4 updates.

The adoption of technology is not a purely

technical topic, since multiple aspects need to be

taken into account. Following a paper of Lee &

Coughlin, 2015 (Lee and Coughlin, 2014) there are

ten factors of older adults’ technology adoption;

value, usability, affordability, accessibility, technical

support, social support, emotion independence,

experience and confidence. These ten factors address

four aspects: individual aspects, technology aspects,

social aspects and delivery aspects. During this

evaluation, we focus mainly on technology factors

(design and functional features that affect how older

adults interact with technology) in phase 1 and 2 and

individual factors (characteristics of older adults as

individual users that affect their interactions with

technology) in phase 3. During phase 4, subjects will

be invited to use GOAL by sending out a mass email

and advertisements in local newspapers to get older

adults to sign up to GOAL for themselves. After three

phases in a lab-setting GOAL will be evaluated in the

real environment during this final phase. To get a

broad overview of the adoption of GOAL by the

target population it will be good to also focus on the

social (expectations and needs that arise form the

social and cultural contexts that older adults are in)

and delivery (ways in which technology is

communicated and distributed to older adults for

purchase and use) factors.

A weakness of this study is the selection bias of

the subjects, as using GOAL was voluntary. The

majority of the older adults who were willing to

participate, were technology minded and had basic

skills to use a (smart) phone, tablet or laptop.

Although it is in general desirable to develop

technology and assistive tools for the target

population of less-technologically skilled older adults

and those less motivated in achieving a healthy

lifestyle, this is not necessarily the main target for the

GOAL platform. However, to enhance the adoption

of technology and assistive tools it is important to

take into account the individual, technology, social

and delivery aspects and invite the target group as co-

designers.

ACKNOWLEDGEMENTS

Special thanks go to the subjects who participated in

this study, to Mattienne van der Kamp for his

assistance in carrying out this study and to the

technology developers of RRD, AIT, AU and NG.

The GOAL project (H2020 project no. 731656). is an

EC-funded project under the call ICT-24-2016:

Gaming and gamification.

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ICT4AWE 2019 - 5th International Conference on Information and Communication Technologies for Ageing Well and e-Health