1. Basia Belza, PhD, RN, FAAN University of Washington User Tools and Technologies in Facilitating Community Wayfinding The CDC HAN is a thematic research network within CDC's Prevention Research Centers Program and is supported through the CDC's Healthy Aging Program.

2. Disclosure: Basia Belza The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: No relationships to disclose

3. William A. Satariano Marlon Maus Rebecca H. Hunter Daniela B. Friedman Anna Vandenberg Angie Deokar Laura Farren Lucinda L. Bryant Mariko Toyoji Nai-Ching Chi Sean Mullen India Rose Yuki Durham

4. Abstract Ensuring effective community wayfinding (CWF) is critical for maintaining mobility among older adults. Reduced mobility, associated with either age or disability, is a public health burden. The purpose of this presentation is to discuss the role of user tools and technologies in facilitating CWF in older adults and people with mobility disabilities. Wayfinding tools and aids used by people to support mobility and/or navigation include but are not limited to smartphones, compasses, maps, and written directions. We report the results of a review and synthesis of the literature on user tools and technologies as related to CWF. In our review we include but are not limited to populations with sensory and/or cognitive impairments. We propose new research directions, including the need to better understand the use of tools in everyday settings and how tool-use relates to public health outcomes such as increased physical activity. We summarize opportunities and challenges of user tools and technologies, such as those associated with barriers and the equitable distribution of these technologies in underserved populations. Without a consideration of these barriers, CWF innovations, no matter how efficacious and effective, may only serve to aggravate health and functional disparities by race, ethnicity, and region in aging populations.

5. Purpose Discuss the role of user tools and technologies in facilitating community wayfinding in older adults and people with disabilities. Photo credit: Ed Stollof

6. Tools and Technology – An Ecological View

7. …devices and systems to enhance the ability of individuals and populations to locate themselves and find their way safely through indoor and outdoor environments with ease, efficiency and effectiveness. Wayfinding user tools and technologies are…

8. Types 1.User-based 2.Environment-based 3.User-environment interactive 4.Wayfinding systems Audible Signal, Ed Stollof Easter Seals Project ACTION

9. 1.What innovative WF technologies exist or are emerging to ensure that adults are better able to find their way through indoor and outdoor environments? 2.What are the implications of WF technology and dissemination for public health?

10. Review Steps Plan Develop a process and abstraction forms and a reviewer guide Train team members Identify search strategies and inclusion and exclusion criteria Search & Appraise Run the search Complete primary and secondary abstractions Reconcile reviews Synthesize & Share Extract findings Summarize learnings Disseminate

11. Primary Abstraction n = 106 Secondary Abstraction n = 106 Excluded 485 + 23 = 508 -Published pre-2003 -Non-English language -Basic science -Clinical focus -Pertaining to children -Evacuation systems -Systems that track people with dementia -Computer-focused -Mobility-focused tools -Product dev tech -Not related to CWF -Low tech Selected for Final Review/Analysis n = 83 Our Process Abstraction Reconciliation n = 106 Records Identified and Prescreened n = 591

12. What areas of WF are addressed (n=83)? *Percent of the total

13. What types of articles are used (n=83)? Percent of the total

14. What was the setting (n=83)? Percent of the total

15. What types of technologies are addressed (n=83)? Percent of the total

16. Does the technology address functional factors related to use (n=83)? Percent of the total

17. Observations 1.Most studies of adults with sensory deficits, e.g., vision impairment; few studies of older adults. 2.Most studies from information sciences and environmental psychology. 3.Most studies based on small samples. 4.Limited focus on issues of socioeconomic barriers to access and cultural impact of WF technology.

18. New Directions 1.Use of technologies in everyday settings 2.Link to public health outcomes 3.Accessibility, demographic, socioeconomic, and cultural factors 4.Collaborations between WF technology developers and public health professionals

19. Thank you for your interest ! Contact: basiab@uw.edu This presentation is the result of work conducted by the CDC Healthy Aging Research Network. The CDC Healthy Aging Research Network is a Prevention Research Centers program funded by the CDC Healthy Aging Program. This research was supported in part by cooperative agreements from CDC's Prevention Research Centers Program: U48-DP-001911, 001908, 001921, 001924, 001936, 001938, and 001944. The contents of this presentation are solely the responsibility of the authors and do not necessarily represent the official views of the CDC.