Research

Presentations

1. Title: Occupant Activity Profiles From Smart Home Sensor Event Streams

Authors: Aden-Buie, G., VandeWeerd, C., Yalcin, A.

Presented at Informs Annual Meeting Dallas, TX, 2017

Abstract: Faced with a growing elderly population, learning and characterizing activity profiles of smart home occupants will support senior health care management for older adults living in homes augmented by ambient intelligence solutions that combine ubiquitous computing and artificial intelligence. In this work, we explore a bag of n-grams approach for creating occupant-specific activity profiles from event streams collected from passive, embedded sensors in real-world sensor networks in the homes of several older adults.

2. Title: Activity Estimation using Ambient Sensor Network Data

Authors: Wang, Y., VandeWeerd, C., Yalcin, A.

Presented at Informs Annual Meeting Dallas, TX, 2017

Abstract: Data from ambient sensor networks deployed in residential environments is used in daily activity recognition, behavior pattern discovery, abnormal behavior detection and physical and mental health assessment. In this work, we describe a spatio-temporal status tracking algorithm based Pyroelectric Infrared (PIR) motion sensor data to estimate resident's location, time outside of home and sleep behaviors. The significance of this information is discussed as it relates monitoring chronic health conditions and enabling older adults to age-in-place safely and independently.

3. Title: Ambient Sensor Monitoring: Detecting Loneliness and Depression in Older Adults via Passive Home Sensing

Authors: VandeWeerd, C., Agu, N., Aden-Buie, G., Yetisener, E., Radwan, C., Lent, K., Watkins, C., Roberts, M., Behzadnia, P., & Yalcin, A.

Presented at 144th Annual Scientific Meeting of the American Public Health Association, Denver, CO, November, 2016.

Abstract: Circumstances of aging predispose many older adults to depression, loneliness, and social isolation. For seniors, poor socioemotional health is also associated with increased mortality, decrease in cognitive function, and poor quality of life. Due to the subtle onset of these changes, home sensing presents an opportunity to detect loneliness and social isolation before adverse health events occur.

4. Title: Assessing Older Adults' Socio-Behavioral Health Using Electronic Health Record Data

Authors: VandeWeerd, C, Lent, K., Agu, N., Sappington, E., Roberts, M., Behzadnia, P., & Yalcin, A.

Presented at 69Th Annual Scientific Meeting of the Gerontological Society of American, New Orleans, LA, November, 2016

Abstract: Electronic health records (EHR) have become the new standard for healthcare record management. While this technology is a requirement of recent healthcare reform policies, the benefits of real-time entry and access to health data have been widely received by both practitioners and patients. EHR systems allow practitioners to capture a greater picture of health and add context to clinical findings through the socio-behavioral indicators (i.e. risky health behaviors). The objectives of this study are to identify the current collection practices of socio-behavioral health data in an EHR environment and identify trends in older adults' reported socio-behavioral health.
Socio-behavioral health data was extracted from the EHR system employed in The Villages (n=45,173), an active-lifestyle retirement community with its own healthcare system in central Florida. This data focused on seven domains: tobacco and drug use, medication adherence, advanced directives, communication, alcohol use, sexual history, and health risk. Data were analyzed for trends in reporting and overall frequencies. Findings demonstration that collection of socio-behavioral data is inconsistent across domains; some areas are well captured (i.e. tobacco use, advanced directives, health risks) and others lack sufficient data (sexual history, drug use). Results provide insight on clinical areas that may benefit from further exploration including, a low presence of advanced care directives in the patient population (27% of those asked, indicate no ACD) and limited sexual health information (data was available for 3% of the total patient population).

5. Title: Detecting Mental Health Changes in Seniors via Ambient Sensor Monitoring

Authors: VandeWeerd, C., Agu, N., Aden-Buie, G., Yetisener, E., Radwan, C., Lent, K., Watkins, C., Roberts, M., Behzadnia, P., & Yalcin, A.

Presented at 69Th Annual Scientific Meeting of the Gerontological Society of American, New Orleans, LA, November, 2016.

Abstract: Physical and emotional events throughout the aging process (i.e. health decline, death of a spouse) predispose many older adults to depression, loneliness, and social isolation. For seniors, poor socioemotional health is also associated with increased mortality, decrease in cognitive functioning, and poor quality of life. Recognizing the subtle onset of these changes (i.e. gradual increase in sedentary behavior, decline in activities of daily living [ADLs]), home sensing presents an opportunity to detect loneliness and social isolation before correlated adverse health events occur. AlwaysNear is a 24/7 in-home ambient sensor system that monitors ADLs (i.e. mobility, sleep, hygiene) and generates notifications when ADLs deviate significantly from baseline levels.

AlwaysNear was installed in the homes of older adults in The Villages, Florida. In addition to sensor data collection, participants were regularly asked general questions about their physical (i.e. changes in diagnoses, level of bodily pain) and socioemotional health (i.e. levels of loneliness as measured by the UCLA Loneliness Scale, depression as measured by the PHQ-9). The objective of this study is to further previous research that suggets a relationship between monitored time spent inside and outside the home and self-reported loneliness and poor socioemotional health. Logistic regression was employed and identified a negative relationship between time spent outside the home and mental health and indicates that monitoring passive can be an effective method of predicting loneliness and risk of depression in older adults. Implications for policy and practice will be discussed.

6. Title: Qualitative Assessment of Care-Seeking Behaviors of Mental Health Services Among Community Dwelling Older Adults in Florida

Authors: Fishleder, S., Tyler, S., Corvin, J., & VandeWeerd, C.

Presented at Academy Health Annual Research Meeting, Boston, MA, June, 2016.

Abstract: Mental health issues, and in particular depression, are common among community-dwelling older adults, influencing morbidity, mortality, quality of life, and suicide rates. Many psychological conditions are comorbid, and are major risk factors for somatic chronic diseases, which already disproportionately affect the older adult population. Despite being a large, high needs group, this population shows more severe outcomes and lower utilization of mental health services, when compared to younger populations. This underutilization is attributable, largely, to a lack of help-seeking behaviors. This study seeks to qualitatively explore barriers and facilitators to help-seeking behaviors among older adults in The Villages, a large planned community of older adults in Central Florida

7. Title: Doctor-patient or doctor-doctor communication? Understanding challenges in aging clinical care

Authors: Logan, R., Fishleder, S., McDaniel, M., Lyons, K., Corvin, J., & VandeWeerd, C.

Presented at Aging in America Conference, Washington, D.C., March, 2016

Abstract: Coordinated care and patient-centered medical homes are becoming the standards in current clinical practice. However, many older adults are receiving medical care without much coordination between the multiple clinicians that serve them. Older adults are experiencing difficulties in effectively communicating with providers, and also express concerns that their providers do not have a method to communicate amongst one another.
This study explored challenges older adults may face accessing health care services by conducting 105 focus groups with adults 55+. Emerging themes included difficulty communicating with providers due to provider's unfamiliarity with their medical history; provider's specialization limiting what can be discussed during the medical visit; and provider's lack of communication with patients' other health care providers.
In the primary stage of data analysis, a priori codes were used and principles of grounded theory were employed throughout subsequent analytic phases. This work supports the current literature in promoting improved communication channels not only between patients and providers but also between providers in order to provide integrated, quality health care to aging patients.

 

8. Title: Barriers and facilitators to mental health help-seeking among older adults in The Villages, Florida: A Qualitative Study

Authors: Fishleder, S., Tyler, S., Corvin, J., VandeWeerd, C.

Presented at 143rd Annual Meeting and Exposition of the American Public Health Association, Chicago, IL, November, 2015

Abstract: Depression and mental health issues are common among older adults. This population also shows more severe outcomes, and lower utilization rates of health services compared to younger populations, attributable in part, to a lack of help-seeking behaviors. This study seeks to qualitatively explore barriers and facilitators to help-seeking behaviors among older adults in The Villages, a large planned community of older adults in Central Florida.  Analysis focused on Phase 3 of a larger mixed-methods health assessment conducted by the 最新天美传媒 (USF) Health. Thematic analysis of 29 focus groups (n=144) was undertaken to assess themes related to mental health. Broader themes relating to perceptions of depression, accessing mental health care services, and barriers to seeking treatment for depression were identified. Although residents were asked about mental health services in general, residents almost universally focused the discussion on depression. Participants identified the following barriers to seeking help: perception of depression as a normative part of aging; generalized stigma regarding mental health; an uncertainty of when and where to seek help; and lack of insurance coverage. Facilitators include: recognizing the importance of mental health; a desire to refer friends, family and neighbors to services; informal support groups as a first step to seeking care; and the physicians role in treating depression. Planned retirement communities are unique opportunities to explore perceptions of mental health help-seeking among older adults. Future public health efforts must focus on making mental health treatment more known, accessible, and acceptable among older adults.

9. Title: Reaching out for help: Perceptions about depression and mental health services among community-dwelling older adults in central Florida

Authors: Fishleder, S., Tyler, S., Corvin, J., VandeWeerd, C.

Presented at Gerontological Society of America's Annual Scientific Meeting, Orlando, FL, November 2015

Abstract: Later life is often accompanied by a disproportionate prevalence of mental health issues, more severe outcomes, and lower utilization rates of health services. These disparities are partly attributable to a lack of help-seeking behaviors. This study examines barriers and facilitators to help-seeking behaviors among older adults in The Villages, an active-living older adult community in Central Florida Methods: Analysis focused on Phase 3 of a larger mixed-methods health assessment conducted by the University of South Florida (USF) Health. Thematic analysis of 29 focus groups (n=144) was undertaken to assess discussion related to mental health services in the community. Larger themes were identified, including perceptions of depression, accessing mental health services, and barriers to seeking treatment Results: Residents almost universally focused the discussion on depression, despite focus group questions asking broadly about mental health services. Barriers to seeking help include: perception of depression as a normative part of aging; generalized stigma regarding mental health; an uncertainty of when and where to seek help; and lack of insurance coverage. Facilitators include: recognizing the importance of mental health; a desire to refer friends, family and neighbors to services; informal support groups as a first step to seeking care; and the physicians role in treating depression Discussion: The informal support available to older adults are invaluable tools to identify depression and promote health-seeking behaviors. Strong doctor-patient relationships are essential to facilitating the early stages of mental health clinical care, and liaisons from their office may serve to guide older adults through insurance concerns.

10. Title: Aging in Place: The Potential of Sensor Technology to Increase Seniors' Independence

Authors: VandeWeerd, C., Agu, N., Aden-Buie, G., Hammett, J., Yetisener, A., Radwan, C., Salow, V., Yalcin, A.

Presented at Gerontological Society of America's Annual Scientific Meeting, Orlando, FL, November 2015

Abstract: As the number of adults aged 65 and older in the US doubles, the need for innovative care solutions becomes increasingly paramount. Sensor technology can enable "aging in place" by detecting changes in daily living that indicate onset or progression of conditions including diabetes, depression, and sensory impairment. AlwaysNear is a 24/7 in-home sensor system that monitors the frequency and timing of daily activities (e.g. sitting) and generates notifications when activity levels deviate significantly from individualized baselines. AlwaysNear can increase seniors' independence by enabling caregivers to preempt avoidable health decline. The objectives of this study were to evaluate AlwaysNear's ability to detect 13 activities and to generate timely notifications when activity frequencies or timing change by predetermined amounts. To validate the system's detection capability and notification system, eight contact sensors and one motion sensor were embedded into a Living Lab and 12 notifications (e.g. infrequent refrigerator openings) were programmed into the system. Target activities were performed by researchers and all activities, excluding toileting, were accurately detected by the sensors. Most activity notifications (levels above baseline) were reliably generated, however, inactivity notifications (levels below baseline) did not generate reliably. Recommended system improvements included more sensitive motion sensors and more reliable inactivity notifications. The sensors' detection capabilities, however, already offer a promising mechanism to facilitate seniors' independence. Further, AlwaysNear has the potential to integrate with electronic medical records and homecare services to enhance the current prevention capabilities of geriatric medical practitioners and improve the health and safety of seniors.

11. Title: Ambient Sensor Monitoring to Enable Aging in Place for Older Adults

Authors: Yalcin, A.., Agu, N., Aden-Buie, G., Hammett, J., Yetisener, A., Radwan, C., Salow, V., VandeWeerd, C.

Presented at 143rd Annual Meeting and Exposition of the American Public Health Association, Chicago, IL, November, 2015

Abstract: The number of adults aged 65 and older in the US is predicted to double by 2040. Early detection of onset or progression of chronic conditions among this growing population can prevent costly health complications, decrease caregiver burden, and increase seniors' independence. AlwaysNear is a 24/7 in-home ambient sensor system that monitors 13 activities of daily living (ADLs) (e.g. toileting, mobility, sleep) and generates notifications when ADLs deviate significantly from baseline levels. Changes in ADLs can indicate chronic conditions including diabetes, depression, and sensory impairment.
The objectives of this study were to evaluate AlwaysNear's ability to detect 13 target ADLs and to generate timely notifications when ADLs deviate from baseline levels. To validate the sensors' detection capability and notification system, eight contact sensors and one motion sensor were embedded into a Living Lab and 12 notifications (e.g. excess time in bed; too few refrigerator openings) were programmed into the system. Target activities were performed by research assistants and all activities, excluding toileting, were accurately detected by the sensors. Most activity notifications (ADLs in excess of baseline) were reliably generated, however, inactivity notifications (ADLs below baseline) did not generate reliably.
Recommended system improvements included more sensitive motion sensors and more reliable inactivity notifications. The sensors' detection capabilities, however, already offer a promising mechanism to facilitate seniors "aging in place". Further, AlwaysNear has the potential to integrate with electronic medical records and homecare services to enhance the current prevention capabilities of geriatric medical practitioners and improve the health and safety of seniors.

12. Title: Ambient Intelligent Implications in Healthcare

Authors: Aden-Buie, G., Yalcin, A., Hammett, J., Agu, N., Radwan, C., Yetisener, E., Salow, V., & VandeWeerd, C.

Presented at Institute of Industrial Engineers Annual Conference & Expo, Nashville, TN, May, 2015

Abstract: In the past century, the world has experienced unprecedented growth in life expectancy concurrent with a growth in elderly population. Between 2010 and 2050, the number of people aged 65 and older is expected to more than double to exceed 88 million by 2050 in the United States. Ambient intelligence merges ubiquitous computing, embedded sensors, and artificial intelligence to monitor, adjust and respond to the environment of the user. This presentation will explore the potential of ambient intelligence for applications in health care, primarily with a focus on senior health care management, and present up-to-date results of our interdisciplinary research group's work related to the design, deployment and evaluation of sensory systems used to monitor activities of daily living and improve health and well-being of independent older adults living in an active retirement community.