“The Technology Works Fine, but…”
Barriers to Involving Older Adults in Co-Design for Digital Health Innovation: A Structured Case Study Reflection
DOI:
https://doi.org/10.54337/aau.icdvrat26.32Abstract
This paper examines the barriers to involving hospitalised older adults in co-design for digital health innovation. It draws on ZenctuaryVR+, a research project funded by the Hungarian National Research, Development and Innovation Office (NKFIH), in which a nature-based virtual reality (VR) application supporting the wellbeing of older adults in long-term hospital care is co-designed together with patients and healthcare professionals and will subsequently be evaluated in a longitudinal randomised controlled trial (RCT). Applying the Nonadoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework (Greenhalgh et al., 2017), we deliberately treat co-design itself, rather than the VR system it produces, as the innovation under analysis. Across four domains (technology, adopter system, organisation, and wider context) we identify compounding complexity arising from grant-funding constraints, ethical approval processes, hospital institutional structures, and ageist imaginaries embedded in gerontechnology design. Offered as a structured case study reflection based on seven interviews, two observation sessions and three co-design workshops, the paper argues that co-design in this context is not simply difficult but structurally complex in ways that resist disaggregation, and it draws practical implications for participatory VR research with hospitalised older adults.
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