This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included.
The aging society posits new socioeconomic challenges to which a potential solution is active and assisted living (AAL) technologies. Visual-based sensing systems are technologically among the most advantageous forms of AAL technologies in providing health and social care; however, they come at the risk of violating rights to privacy. With the immersion of video-based technologies, privacy-preserving smart solutions are being developed; however, the user acceptance research about these developments is not yet being systematized.
With this scoping review, we aimed to gain an overview of existing studies examining the viewpoints of older adults and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology.
A total of 22 studies were identified with a primary focus on user acceptance and privacy attitudes during a literature search of major databases. Methodological quality assessment and thematic analysis of the selected studies were executed and principal findings are summarized. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines were followed at every step of this scoping review.
Acceptance attitudes toward video-based AAL technologies are rather conditional, and are summarized into five main themes seen from the two end-user perspectives: caregiver and care receiver. With privacy being a major barrier to video-based AAL technologies, security and medical safety were identified as the major benefits across the studies.
This review reveals a very low methodological quality of the empirical studies assessing user acceptance of video-based AAL technologies. We propose that more specific and more end user– and real life–targeting research is needed to assess the acceptance of proposed solutions.
As a response to the health care challenges related to an aging society [
While AAL is mainly perceived as helpful and beneficial when it comes to assisting older individuals [
Traditionally, technology acceptance has been measured with the Technology Acceptance Model (TAM) [
With a focus on privacy, Lorenzen-Huber and colleagues [
Depending on the unfolding of these relevant factors in this mental tradeoff, positive aspects of technology may even override privacy concerns (eg, [
Overall, the role privacy plays in the acceptance of AAL technologies is complex, can be seen as a tradeoff between barriers and benefits or a multidimensional phenomenon, and its evaluation is dependent on a specific point in time and on the way it is examined. It is therefore timely to review and map the existing literature in this field. Therefore, a scoping review method was applied with the aim of gaining an overview of existing studies examining the viewpoints of older adults (aged≥50 years) and/or their caregivers on technology acceptance and privacy perceptions, specifically toward video-based AAL technology.
The more specific objectives of this review were to (1) scope the body of literature about acceptance and privacy perceptions toward video-based AAL technologies; (2) identify methodologies used to measure acceptance and privacy perceptions toward video-based AAL technology; and (3) identify major knowledge gaps and synthesize the knowledge about perceptions toward video-based AAL technology as a guideline for future research.
This review concentrates on AAL technology that is camera/video-based. The reasons for specifically targeting camera/video are two-fold: on the one hand, visual sensors have high potential to provide quality care [
This review was based on a methodological framework developed by Arksey and O’Malley [
The final search took place on August 23, 2021 (and a rerun of databases was performed again in September 2022), and was not restricted by publication date. The reproducible full electronic search strategy of all databases searched is provided in
Studies published in English, Spanish, German, French, Portuguese, Italian, Russian, and Georgian languages were considered, although English search terms were used. The following databases were searched: Web of Science (includes Medline), PsycINFO and CINAHL (by EbscoHost), Scopus, Sociology Abstracts by ProQuest, Google Scholar, and ArXives. Articles were included for this review if they dealt with privacy perceptions and acceptance attitudes of potential or current users of video-based AAL technology, such as older adults (50+ years) or disabled people (of any age) and their caregivers, family members, nurses, medical staff, and bystanders (of any age). The full table of inclusion and exclusion criteria can be accessed in
In the next stage, full texts of the 136 articles were retrieved in Mendeley software and were assessed for eligibility on a full-text level by the two researchers independently. Disagreements were resolved by a third researcher and a total of 18 articles were identified for inclusion from the databases searched. Three additional articles were preidentified through personal registers. Reference lists from these publications were manually searched for any reports missed by database searches and personal registers, and one more article was found to be eligible for inclusion in the scoping review, resulting in a total of 22 articles (
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 flow diagram of the study selection process [
Summary of included studies (see Multimedia Appendix 3 for the full table of data extraction).
Study | Country | Design and participants | Technology and setting | Main findings |
Bandini et al [ |
Canada | Mixed methods (quantitative online survey and qualitative semistructured interviews); older adults with medical necessity (n=13, age range 46-65 years) | Egocentric wearable camera. Direct contact with technology: participants recorded their daily routine at home using a head-mounted camera over a period of 2 weeks. | 61.5%-69.3% of participants expressed little concern about having data of their daily life used by clinicians and researchers for monitoring. Participants would be more comfortable wearing a first-person camera at home than in public. All participants agreed that it was important to start and stop the recordings at any time. |
Beach et al [ |
United States | Quantitative (online survey); older adults (1518 disabled and nondisabled adults, age range 45-65 years) | Video systems with/without sound, sensors, motion detectors. No direct contact with technology. Brief description of each technology was presented in the online survey. | Individuals reporting disability had consistently more positive attitudes toward sharing information than those not reporting disability. The level of disability compared to the mere presence of disability influenced the acceptability of technology. Older respondents tended to be more accepting than younger respondents. |
Berridge et al. [ |
United States | Mixed methods (online survey with close-ended and open-ended questions); 273 caregivers working in nursing homes or as assisted living providers (no age reported) | Video systems. No direct contact with technology: sample has had diverse exposure to cameras in facilities in the past but no direct contact with technology was deployed in the study. | Most respondents reported the inappropriate invasion of privacy; concerns regarding dignity regarding camera usage; as well as its potential to demoralize, offend, stress, add undue pressure, intimidate, and show lack of confidence in staff. Noted potential advantages were detecting abuse or determining truth in abuse of theft allegations and care quality improvement. |
Bourbonnais et al [ |
Canada | Qualitative (exploratory semistructured interviews); 20 care managers, family caregivers, and formal caregivers in five nursing homes (age range 34-70 years) | Intelligent video monitoring system (IVS). No direct contact with technology. A presentation of a potential IVS-integrated app and a short video on the IVS was shown to each participant. | Caregivers thought these tools could improve their well-being at work by improving the behaviors of older people, decreasing the noise in the environment, and reducing the stress and the risk of falls. The risk to confidentiality, cyber dependency, and decreased human contact were also noted by caregivers. |
Caine et al [ |
United States | Quantitative (scenario-based online survey); 25 older adults (age range 65-80 years) | Camera, stationary robot (with camera), and a mobile robot (with camera). Direct contact with technology. Participants were given a tour of the tech-aware home and were introduced to the three visual sensing devices (with some privacy-preserving techniques: point-light image, blob image) | The data suggest that privacy concerns are not independent of situation variables. Both device type as well as level of functioning affect privacy concerns in a variety of situations, with privacy concerns being higher when the character in the scenario was high-functioning. Normal video camera images produced more privacy concerns; however, the video camera was rated as more beneficial than the blob tracker. |
Caine et al [ |
United States | Mixed methods (quantitative survey, qualitative interviews, and observations); 18 older adults (age range 69-88 years) | Camera, stationary robot (with camera), and a mobile robot (with camera). Direct contact with technology. Participants interacted with the devices in the R-House Living Lab (participants were asked to imagine being in their home). | Older adults in each of the three monitoring device conditions engaged in privacy-enhancing behaviors (PEBs). The camera was the condition in which participants performed the most PEBs. Nine activities were identified, where the comfort with performing household activities decreased with the monitoring devices being present. |
Demiris et al [ |
United States | Qualitative (videotaped scenarios followed by in-depth interviews); older adults (10 residents of an independent retirement community, aged >65 years) | Firewire webcam. Direct contact with technology. Participants were filmed while undertaking certain activities at home and recordings after silhouette extractions were shown to them during interviews. | Shape extraction can alleviate privacy concerns associated with the use of cameras. Participants expressed no privacy concerns with silhouette images and emphasized the importance of anonymity in the video sequences. They expressed the desire to control the system by being able to turn it off and on, and also determine who has access to the collected information. |
Gelonch et al [ |
Spain | Mixed methods (quantitative self-report questionnaire and qualitative focus groups); older adults with medical necessity and caregivers (N=18, including 9 patients with mild cognitive impairment and medical necessity and their 9 familial caregivers; age range of patients: 65-90 years) | Wearable life-logging camera. Direct contact with technology: participants had to wear the camera (which automatically takes pictures every 30 s) for 7 days throughout the day. | Patients exhibited a good level of acceptance of the camera. However, feelings of embarrassment or worry about the comments that the camera might provoke were reported. Most of the patients and their caregivers reported that they felt relieved when the study ended. Most participants stated that the therapeutic benefits, ease of use, and autonomy of being able to turn the camera off in situations of privacy or discomfort provided sufficient reasons for acceptance. |
Gövercin et al [ |
Germany | Qualitative (focus groups); older adults with medical necessity (22 slightly to severely disabled participants with low to severe risk of falling and their caregivers, age range 50-85 years) | Camera systems and motion sensors. No direct contact with technology. Presentation about different information and communication–based technologies (optical and inertial sensors for the prediction and detection of falls at home) during the focus group discussions. | Participants considered a fall prediction system to be as important as a fall detection system. Although the ambient, unobtrusive character of the optical sensor system was appreciated, wearable inertial sensors were preferred because of their wide range of use, which provides higher levels of security. Security and mobility were two major reasons for people at risk of falling to buy the proposed systems. |
Harvey et al [ |
United Kingdom | Mixed methods (quantitative questionnaire and qualitative interviews); 6 older adults (mean age 68 years) | Wearable time-lapse camera. Direct contact with technology. Participants wore the equipment for 7 consecutive days during free-living activities. | Participants found the camera to be acceptable to use. They reported that the equipment allowed for sufficient privacy for themselves and others. Regarding reactivity, the equipment had little effect on the participants’ day-to-day lives. Regarding safety, participants felt safe while using the equipment. |
Lapierre et al [ |
Canada | Mixed methods (individual interviews that consisted of qualitative and quantitative [questionnaire] assessments); 18 family caregivers (age range 42-87 years) | IVS. No direct contact with technology. Proposed system was explained with a video on the specific technology to each participant before the interview. | Most participants (n=15/18) liked the IVS and were willing to use it. They would worry less if they could be alerted if a care recipient fell, but they were concerned about privacy and cost. Participants had a positive perception of the system and expressed their wishes regarding the kind of alert and the person to contact in case of a fall. |
Lapierre et al [ |
Canada | Qualitative (focus groups); 31 professional caregivers, representing home support services for older adults: nurses, social workers, occupational therapists, physiotherapists, physicians, and managers. | IVS. No direct contact with technology: IVS for fall detection and its operation was explained to the participants by showing them videos of 4 different scenarios of fall detection. | Participants reported that the system would provide the caregiver with a quick response to the fall, documentation of its causes, reduction of its consequences and of false emergencies, absence of a device to wear and of an alarm to be given by the caregiver. The system would reassure the carer and give them more freedom. |
Lapierre et al [ |
Canada | Qualitative (interviews before and after use of the technology); 6 older women (aged≥65 years) | Programmable video monitoring system. Direct contact with technology: three or four cameras were installed in the bedroom, hallway, and bathroom for 7 consecutive nights and were programmed to record when triggered by movement detection for nighttime slots chosen by the participant. Video images were processed (blurred). | Participants had positive opinions of the video system before the implementation; they appreciated the programmable movement detection during chosen time slots, respecting privacy; the light-emitting diode indicating the recording; and the small cameras. After the experiment, participants reported positive experiences, although some expressed discomfort. Two participants felt uncomfortable receiving visitors during the experiment. Overall, choosing time slots for recording and automatic processing of the images had a positive impact on privacy preservation for participants. |
Lapierre et al [ |
Canada | Mixed methods (qualitative interviews and quantitative questionnaires before the implementation, at the midpoint, and at the end); 4 older adults (aged≥65 years) and 4 informal caregivers | IVS. Direct contact with technology: IVS for fall detection was implemented for 2 months at home. In case of a fall, the caregivers received an alert that could include an image of the older adult after the fall. The system had a closed circuit for protecting privacy. | All participants were satisfied with the IVS installation. The caregivers appreciated the fact that the IVS was installed in high-risk zones. However, they did not want the IVS to be installed permanently. Regarding alerts, the older adults liked the image sent to the caregiver so that they could intervene. All caregivers were reassured by receiving images. Finally, all participants appreciated the IVS’s closed-circuit functioning and trusted it to protect their privacy. |
Londei et al [ |
Canada | Mixed methods (interviews and quantitative questionnaires); 25 older adults with a history of fall (aged≥65 years) | IVS. No direct contact with technology: 6-minute video including four fall scenarios was presented to the participants that employed IVS for fall detection. | 96% of the participants were favorable or partially favorable to the IVS. About half (48%) said that they would use it. The other participants did not wish to use it unless they had been left to live alone or if their health condition worsened. The participants favorable and willing to use the IVS gave two reasons: (1) the sense of confidence and security and (2) the intimacy and privacy given by the system. |
Matthews et al [ |
United States | Mixed methods (qualitative interviews and quantitative questionnaires); older adults with medical necessity and their caregivers (9 adults with dementia, age range 73-87 years; 9 family caregivers, age range 44-89 years) | Wearable and wireless camera system. Direct contact with technology: caregiver–care receiver dyads used the system for 3 to 7 days. Caregiver would control when the system was worn and when recording occurred. | Family caregivers gave the technology in general high ratings for making life easy, convenient, and more comfortable, while also reducing privacy and increasing dependency. Their ratings were lower for its role in enabling personal control, safety and security, and interpersonal connectedness, and were the lowest for making life stressful or complicated. |
Mulvenna et al [ |
United Kingdom | Mixed methods (semistructured workshops with quantitative questionnaires and group discussions); people with medical necessity and their caregivers (2 people with dementia and 22 caregivers, age range 22-78 years) | Video-camera monitoring system. Direct contact with technology: living lab workshop. A short movie scenario was shown and used as a starting point for a general discussion of the issues raised on the benefits or not of using video surveillance. | Participants supported the concept of the use of a camera in the homes of people living with dementia, with some significant caveats around privacy. The questionnaire reported that 91% found that the idea of a video camera in the home of a person living with dementia living alone was a very good or good idea; 78% considered it very appropriate or appropriate to use cameras in homes of older people generally. |
Seelye et al [ |
United States | Mixed methods (qualitative interviews and quantitative questionnaires); 8 older adults and their 8 caregivers from family or friends (age range 64-92 years) | Mobile robot. Direct contact with technology: a mobile, remotely controlled robot with video-communication capability was placed in the home of older adults for 2 complete days. | In general, participants appreciated the potential of this technology to enhance their physical health and well-being, social connectedness, and ability to live independently at home. Participants expressed little concern about privacy, although they highlighted the importance of having control and knowledge of who has access to call them through the device. |
Sugihara et al [ |
Japan | Qualitative (interviews); 11 caregivers for people with dementia (age not provided) | Prototype Mimamori cameras. Direct contact with technology: cameras and monitors, with position detection and image capture abilities, were embedded in common spaces except the bathroom and restroom in two group homes. | Positive effects of using the system were: eliminated blind spots in the home and improved working style of caregivers. Negative effects mainly regarded the work stress, as caregivers cannot rest in the break time because of the video recording, and caregivers were heavily stressed about the reduced and violation of privacy rights for themselves, coworkers, and residents. |
Wilson et al [ |
United Kingdom | Qualitative (semistructured interviews); 18 older adults (16 with and 2 without chronic pain) and 2 younger participants for comparative analysis between groups (age range 52-81 years) | Wearable camera. Direct contact with technology: a wearable camera was used every day for 7 days. Camera recorded passive images building a visual diary of the day by automatically capturing at least one image every 30 seconds. | Intrusiveness, importance of others, remembering the wearable camera, and ease of use were the main themes that emerged. Initial expectations were that the wearable camera would be intrusive and difficult to use, and that being seen wearing the camera would evoke negative reactions from other people; however, these expectations were contrary to their experiences. |
Ziefle et al [ |
Germany | Quantitative (online questionnaires); 165 participants, including 78 males and 87 females (age range 17-94 years) | Video-based system. No direct contact with technology: a medical scenario was presented to participants to introduce them to the field of video-based medical homecare applications. | The results highlight trust and privacy as central requirements, especially when implemented within private spaces. The majority of participants would probably not let medical personnel monitor their home. Most participants would probably accept video-based monitoring systems if they would be helpful. There was a clear answer regarding data protection that must be guaranteed. |
Ziefle et al [ |
Germany | Mixed methods (exploratory focus group sessions and a quantitative survey); focus group, n=42 adults (aged 50-73 years) and quantitative survey, n=100 adults (aged 29-93 years) | Microphone, camera, positioning system. No direct contact with the technology. Two short futuristic example movies illustrating integrated ubiquitous technologies were shown in focus groups. | Integration of a camera was not accepted for the bedroom and bathroom in any focus group. Users’ acceptance differed considerably depending on the room type. The main disliked technology type for home monitoring was camera-based systems, followed by the positioning system and the microphone. |
Data extraction was executed by two researchers independently and was charted in a spreadsheet. The extracted data included author, year, title, place of publication, country, purpose, technology and context of use, methods, and main outcomes. In some cases, the authors of the articles were contacted to obtain and confirm the data. Disagreements and questions during the data extraction process were addressed by the third investigator and interrater agreement was reached through their help. The final table of data extraction is given in
In line with the research objective of understanding the various methods used for assessing acceptance and privacy attitudes toward video-based AAL, the characteristics and methodological quality of the single studies were explored using critical appraisal. An adapted version of the Scale to Assess the Methodological Quality of Studies Assessing Usability of Electronic Health Products and Services [
The articles were read several times to identify key values and areas in which acceptance and privacy perceptions related to video-based AAL technology appear in the care of people in need. Data were analyzed with thematic analysis [
The 22 included articles were published between 2006 and 2021, with a rather even distribution over the years. Articles were developed from work conducted in 6 countries, with the most publications coming from the United States (n=7, 32%) and Canada (n=7, 32%), followed by Germany (n=3, 14%) and the United Kingdom (n=3, 14%). Most studies were in published in English (n=20, 91%), with the remaining two selected articles published in French.
The characteristics of the 22 included studies are summarized in
More publications based their research on study participants having direct contact with technology (13/22, 59%) than no direct contact with technology (9/22, 41%). Regarding the former, participants either got to experience the relevant assistive technology in a living lab (n=3, 14%) or the technology was installed in a specific environment (n=10, 45%). Where direct contact with technology was not provided, participants were either shown videos (n=5, 23%), introduced to a scenario (n=1, 5%), or the technology was presented to them through a presentation (n=1, 5%).
Only 4 of the 22 studies obtained a score of 10 or more out of 13 (maximal score of quality rating) in the critical appraisal assessment. The main questions that failed to fulfill the criteria were related to the triangulation of methods, training and externality of the researcher, as well as the number of participants. The full details of the critical appraisal tool and detailed results are provided in
Quality assessment of the selected studies (N=22).
Score (out of 13) | Studies, n (%) |
10 | 4 (18) |
9 | 1 (5) |
8 | 6 (27) |
7 | 3 (14) |
6 | 2 (9) |
5 | 1 (5) |
4 | 5 (23) |
Based on previously proposed models of technology acceptance [
Privacy: Informational privacy attitudes and handling and access to the video material
Intrusiveness
Type of obtained information
Location of a video-based active and assisted living system
Duration of use (control over it)
Privacy concern mitigation
Necessity: medical necessity
Social environment and its influence
Negative effects on caregivers
Bystander
Positive effect on caregivers and family members
Benefits
Security and medical safety
Being independent
Remain at home
Barriers
Dignity and confidentiality
Interference with normal routine
Cyber dependency
Decreased human contact
Regarding the overall acceptance of video-based AAL, the results from the selected 22 studies show that acceptance attitudes toward video-based AAL technologies are rather conditional. Few studies reported more concerns over the use of monitoring systems than advantages [
Most of the studies reported much higher levels of trust in health care providers than in insurance companies and the government. Selected studies also show that participants agree that relatives, family members, and health care providers can have access to the video material, although there is slight interstudy variation in this regard. For example, Bourbonnais et al [
Invading physical as well as emotional privacy was reported as worrisome across the studies by the participants. Ziefle et al [
The privacy-by-design paradigm in technology allows data protection through inherent technology design [
Most studies showed that bathrooms and bedrooms are the areas where the installation of video-based AAL systems is accepted the least by individuals. Demiris and colleagues [
Most of the selected studies conveyed the idea that it is very important for individuals to have control over the duration of use of a video-based AAL system; in particular, they wish to turn it on and off whenever they like. Participants believed that this ability of a system was an advantage that also maintains privacy. Likewise, most of the studies showed that participants were not happy with the idea of a permanent installation of a monitoring system without them having control over the duration of its use.
Participants across the studies identified several positive aspects that helped prevent privacy concerns, including privacy filters that guaranteed anonymity of the filmed subjects; having control over the system in terms of choosing its location and time for recording; and in the case of wearable cameras, the egocentric point of view of the camera, which did not show the user’s face alleviated participants’ worries. Moreover, studies showed that the greater the perceived need for help, the more privacy one may be willing to give up.
Medical necessity was reported as one of the greatest predictors and modulators of acceptance attitudes toward video-based AAL technologies across all included studies. The perceived benefit-to-cost ratio appeared to increase with the level of medical necessity, which also included more readiness to share information or accept potential privacy threats.
Some studies mainly identified possible negative effects on formal caregivers, such as feeling threatened by being under constant surveillance [
Most participants across the studies expressed concerns about the presence of household members, visitors, roommates, or facility staff in the video. Some of them felt uncomfortable receiving visitors, coupled with the fear of explaining the installed system to them. The need for consent from the bystanders was raised. Interestingly, two studies using a wearable camera [
Half of the selected studies integrated caregivers, including formal caregivers from institutions or family members. The thematic analysis demonstrated that a video-based AAL system could alleviate anxiety in caregivers by detecting medical emergencies, could give them more peace of mind, and increase their well-being in general. Caregivers from the facilities also noted that their workload could be greatly alleviated using these technologies, which would also result in better care practices. However, caregivers also noted the possible negative effects of video-based AAL technologies, which are described in further detail in the Barriers section below.
All selected studies agreed that the biggest benefit of video-based AAL technology was detecting medical emergencies, which then leads to feelings of security and peace of mind. People are willing to accept surveillance, and even the loss of privacy it entails, when the result is greater security of person and property and/or faster response to emergency situations. Apart from detecting emergencies, some studies also reported a great benefit in the documentation of emergencies or explanation of falls, such as checking where the resident is hit in the falling accident [
Participants across the studies agreed that proposed video-based AAL technologies promoted more autonomy and the ability to live more independently whether in their own home or a residential facility. In the case of living independently in their own homes, proposed technologies reduced their fear of being alone at home and promoted a sense of confidence and security.
The ability to be autonomous and independent led participants to appreciate the possibility to remain in their own homes and feel safe.
With privacy being the main threat in the video-based AAL technologies, we here present some other barriers identified through the thematic analysis. Besides the two main barriers presented below, two other less prominent barriers identified were the potential of cyber dependency and decreased human contact.
The risk to confidentiality and concern over dignity was often raised across the studies in relation to the video-based AAL technology. Feelings of vulnerability, embarrassment, “feeling stupid,” or the potential of monitoring technologies to demoralize them and arouse negative emotions were also reported among participants of the selected studies.
Participants changing their behaviors because of the technology in question was detected across the studies. Caine et al [
Video-based AAL technology acceptance research still has a long way to go. This scoping review managed to grasp some important points of this process. We synthesized existing knowledge about the benefit-barrier tradeoff of video-based AAL technologies, and further identified knowledge gaps and directions for future research.
To synthesize existing knowledge on attitudes and perceptions of technology acceptance and privacy, a thematic analysis across the 22 selected studies was performed. Five main categories emerged in this process: Privacy, Medical Necessity, Social Environment and its influence, as well as separately grouped Benefits and Barriers. The latter two themes are usually weighted off against each other and hence play a crucial role when it comes to the decision of accepting or rejecting assistive technology [
Privacy, as the main emerging category, presented not only as a notion of threat or concern, but further branched into six identified subcategories depicting multiple aspects of the construct and demonstrating that privacy attitudes are rather conditional and tradeable. Similarly, in the model of preimplementation acceptance [
Previous models [
With so many factors playing a role in the acceptance of video-based AAL systems, specific questions based on real-life practice need to be addressed in future studies to obtain an accurate picture of user acceptance. During our literature search, tens of general technology acceptance studies were identified; however, only 22 of them focused specifically on video-based AAL acceptance. This is important to note, as each technological solution has its own specifications and it is very difficult to talk about general technology acceptance. This is particularly evident since even when considering only video-based AAL technologies, acceptance depends on numerous variables. Hence, more specific, end user–focused, and real life–targeting research needs to be done, where the type of technology, obtained data thresholds, control over the system, and user specificities such as context and needs are taken into account. This is particularly evident given that in 9 of the selected 22 studies, the participants did not even have any direct contact with the proposed technology when answering questions about its acceptance. This point can be taken to another level by observing an interesting tendency across the studies: even when participants rated the proposed system as favorable, this would not always translate into their willingness to use it. This discrepancy between attitudes and behaviors has been well-documented for a long time [
Overall, it is very important to note that the panorama of published studies reveals a tremendous methodological weakness, as they fail to consider and report relevant methodological aspects. Research in this area still seems to be in an exploratory stage; hence, more effort is needed to take off from this phase. Taking all this information into account, studies of higher methodological quality targeted at specific technologies are needed to answer the questions of user acceptance and privacy in video-based AAL.
Search strategy.
Inclusion and exclusion criteria.
Data extraction.
Critical appraisal tool and adaptation procedure.
active and assisted living
Preferred Reporting Items of Systematic Reviews and Meta-Analyses
Preferred Reporting Items of Systematic Reviews and Meta-Analyses Extension for Scoping Reviews
red, green, blue
red, green, blue with depth
Technology Acceptance Model
Unified Theory of Acceptance and Use of Technology
This work is funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement number 861091 for the visuAAL project.
None declared.