The Adoption of “Silver” E-health Technologies

©2014 Elena Bellio, Luca Buccoliero 1

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The Adoption of “Silver” E-health Technologies

First Hints on Technology Acceptance Factors for elderly

in Italy

Elena Bellio: Bocconi University – Milan - ItalyLuca Buccoliero: Bocconi University – Milan -

Italy


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abUniversità Bocconi, Marketing Department and CERMES

Università Bocconi, founded in 1902, was the first Italian university to grant a degree in management.

For over a century, Bocconi has played a leading role in Italy's social and economic modernization. It has remained true to its founding values of being a major research university, with democratic values and open to the world, as well as financially and politically independent.


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abMarketing Department and CERMES Research Center at Bocconi The Department of Marketing and the Center

for Research on Marketing and Services (CERMES) aim at developing research projects on the crucial themes of customer orientation and competitiveness in the service sectors.

Bearing in mind 1 main element:• The empowerment of

customers – citizens - patients.


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abCitizens Lab

Public, healthcare and social marketing are the research priorities of «Citizens Lab»;

«Citizens Lab» fosters innovation through marketing strategies and tools in the area of public services provided to citizens (in markets or quasi-market contexts or where public administration is the main player).

The main research fields of Citizens Lab include: Healthcare services (hospitals and local healthcare units) Sm@rtcities and Public utilities (transportation, urban network, energy,

telecoms, etc.) Not for profit sector and Corporate Philantropy Value creation for patients and citizens through empowerment Territorial branding and value Social marketing: the systematic application of marketing, along with other

concepts and techniques, to achieve specific behavioural goals for a social good


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ab«Citizens» Lab researches

Patient Behaviour

• Healthcare services use

• Patient Empowerment

• Patient Trust• Innovation

acceptance

Citizen-Customer Behaviour

• Public Services use• Lifestyle• Empowerment and

participation• Citizen Trust

Senior Citizen

Behaviour

• Attitude towards innovation

• Attitude towards healthcare

• Consumption behaviour

• Senior Citizen Trust

Donor Behaviour• Understanding

donor’s motivations

• Innovation in fundraising

Social Marketing and «consumer» behaviour


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abAgenda

A «marketing approach» to ageing society;

Literature review;

Our «Silver» Technology Acceptance Model;

Methodology;

Discussion and conclusions.


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A «marketing approach» to ageing

society


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abMarketing???? Please, consider the following definition….

« Marketing is the activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large».

(American Marketing Association)


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abA new perspective

FROM the 4 “P”…

TO the 4 “C”...

ProductPricePlacePromotion

Citizens’ needs and wantsCost to the citizenConvenienceCommunication


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abElderly population: a marketing approach

Success factors: interconnecting new technologies and market

needs; understanding senior citizens’:

• behaviours;• consuming time;• ways of living.

Developing new market opportunities.


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abSilver citizens meet Technologies

Interconnection of both technologies and market need is necessary;

Understanding consumers’: Behaviours; Perceptions; Life styles.

Giving voice to the silver population is the key to really understand opinions and perspectives.


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Silver citizens meet Technologies


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abSilver citizens meet Technologies

Silver citizens are no longer seen merely as consumers with lots of time and money;

Silver citizens often feel uneasy in their everyday life, and demand home services (IT systems allow a wide range of service provision);

Silver citizens are more authonomous than in the recent past;

Life styles are changing;

They must be considered as a mixture of needs and interests which must be understood.


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abTargeted market research: theelderly are not a homogenous segment Financial

situation Health

conditions Preferences,

needs, values Consumption

behaviour Responses to

advertising campaigns

Skills

the current use of different ICTs by seniors- computers, Internet, mobile phones and consumer electronics

access, frequency, purposes of usage by each age group within a senior aged;

uptake of ICT according to occupation based social status, income, gender and educational attainment, health condition;

ICT access and usage by people with and without an impairments and disabilities;

ICT related attitudes towards the design of ICT products;

affordability of ICT/ICT services for seniors, availability of public funds


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«Silver» Technology Acceptance Model


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abObjectives

To explore the factors that influence technology adoption, particularly where they differ from the factors that have proved to be important in predicting the acceptance of technologies by younger generations;

To reveal cultural differences and similarities in older people’s ICT adoption and use.


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ab«Silver» Technology Acceptance Model


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abResearch hypothesesH1: The influence of

external variables (age, education, family status, occupation, income, health status, concerns) on perceived usefulness and perceived ease of use;

H2: The influence of social norms on perceived usefulness and perceived ease of use;

H3: The influence of perceived usefulness and perceived ease of use on behavioural intentions;

H4: The influence of perceived usefulness and perceived ease of use on actual use.


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abInvestigated Technological Areas

Internet, personal computer and peripherals, phones, smartphones and other communication devices;

Electronic devices used in daily life for housekeeping (microwaves, dish washer, etc.) or for entertainment (blue ray player, digital camera, etc.);

Electronic devices for managing personal health (aerosol device, glucometer, etc.);

Automated devices for smart houses (electric shutters, automatic aids for mobility, etc.).


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Methodology


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abMethodology

A questionnaire was drawn up. It was made of 42 questions divided into 7 sections:

- Personal data;- Use of Internet;- WEB, PC, communication;- Consumer Technology Goods;- Technology for Healthcare;- Domotic consumer applications;- Final opinion.

It addressed people over 65 years old. Most of the answers were based on a scale from 1 to 7, where 1

corresponds to strong disagreement and 7 strong agreement. There were also some dichotomist questions (yes or no).

109 questionnaires were filled out in Italy between June and September 2013. Once the data was collected the analysis phase started.


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Discussion


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abThe sample (1)

67% of female and 33% of male; The average age is 72.20 years while the oldest person is 90

years old; The 98.2% of the sample is Italian; About the 58% of the sample stays in cities instead about the

39% in small towns; The majority of the respondents (84.3%) is not working, in fact

82.4% declares to be retired; As for the family status, our sample is composed as follows:

• Married or in a couple account for 58.3%;• Widowed seniors represent the 24.1% of the total;• 11.1% are single;• separated or divorced seniors account for 6.5%.

32.4% of the sample lives alone.


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abThe sample (2)

Family bonds:• only 5.6% of the sample declares it “doesn’t have any relatives or son”;• in 9.3% of the cases relatives are living with the respondent;• in 14.8% they live in the same building. • the highest percentage is when relatives are “living in the same city“

(48.1%);• in 8.3% of cases relatives are “living in a city not far away”;• instead in 13.9% of the cases relatives are “living in a city far away”.

Health status:• the majority of the enrolled seniors has few symptoms (61.5%);• some of them face difficulties in regular activities (15.6%) ;• 13.8% feels perfectly well and has no symptoms;• Only one respondent has important symptoms and requires help and

frequent medical care. To better understand life styles and routine, a “personal frailty

index” was calculated by assessing the level of difficulty in carrying out possible daily activities. The more a person finds it hard to conduct the listed activities, the more he is considered frail.


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abInternet

About half of the respondents does not use the internet (47.1%);

People are mostly either using internet less than once a day (19%) or are always connected (20%);

Internet usage didn’t differ according to people living areas.;

The most common place to access the Web is home (50.5%). Only 2.9% of the people surf Internet through the wireless network and in mobility.

Most of the people who connect to the internet use a desktop computer (33.3%) or a laptop (28.6%) while only 3.8% uses smartphones or tablets.

38.2% of the sample doesn’t know what social networks are, in the rest of the sample 22.2% of the people use Facebook and 3.7% use Twitter.


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abActivities performed by internet users


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abPc and communication devices


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abHealth devices


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abDomotics


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abSEM 1: Internet


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abSEM 2: Health technologies


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abSEM 3: PC & communication


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abSEM 4: Domotic technologies


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Conclusions


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abHypothesis 1: external variables

The first hypothesis enables to understand how external variables influence perceived usefulness and perceived ease of use in the case of the technological areas considered.

The presence of relatives living close or far from the enrolled person has a positive significant impact on the perceived usefulness when considering Internet, pc and communication technologies and domotics, while the frailty index negatively impacts on the ease of use perceived in case of pc and communication technologies, health technologies and domotics. In case of Internet the ease of use is positively linked to educational levels.


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abHypothesis 2: social norms

The second hypothesis enables to understand how social norms influence perceived usefulness and perceived ease of use in the case of the four technological areas considered.

In the four technological areas considered social norms are highly significant and positively linked to perceived usefulness. The positive influence is also registered in case of ease of use for internet, health technologies and domotics while the significant relationship becomes negative when considering pc and communication technologies.


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abHypothesis 3: perceived usefulness and ease of use on behavioural intentions The third hypothesis enables to understand the influence

of perceived usefulness and perceived ease of use on behavioural intentions.

The most significant influence is registered for health technologies with an extremely high positive relationship in case of perceived usefulness and an high significant positive relationship as for perceived ease of use.


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abHypothesis 4: perceived usefulness and ease of use on actual use The fourth hypotesis enables to understand the influence of

perceived usefulness and perceived ease of use on actual use.

The most significant influence is registered for internet with a high positive relationship in case of perceived usefulness and an extremely high significant positive relationship as for perceived ease of use.


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abManagerial implications

ICT success in supporting ageing society dynamics requires that new strategic approaches are adopted, both by industries and by public bodies.

First, technologies must be strictly linked with a clear analysis of silver citizens’ needs and demand. Traditionally, innovation has been characterized by a “technology” driven approach rather than by a “market” driven approach and too often the customer perspective has been missing.

Moreover, the elderly have been often considered as a homogenous segment of customers, and therefore no or limited efforts have been put on targeting different segments.


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abManagerial implications (2)

On the opposite, different segments with heterogeneous consumption behaviours are identifiable according with the following variables: health conditions;personal frailty; family status;social relationship.

Each segment should be understood as a mixture of needs, perceptions and interests that must be investigated in order to provide the right “value proposition” for ICT solutions.


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abFurther research

Further analysis is in progress in order to improve the magnitude and the significance of the sample. Moreover, a comparative analysis with different Countries could be useful in order to present an international benchmark and to highlight the role of different national cultures.


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Thank you

[email protected]@unibocconi.it

The Adoption of “Silver” E-health Technologies

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