Developing an ecosystem of advanced digital services for healthy ageing by a co-creation methodology: preliminary results of the AGAPE project

Background: Digital solutions can support healthier ageing and better functioning throughout life; the AGAPE project aimed to co-create and implement a digital ecosystem of services to promote Active and Healthy Ageing, with the involvement of Older adults (OAs) and their formal and informal caregivers. The project’s co-creation methodology followed five phases: Pre-selection of devices; Focus groups and questionnaires; Workshops and Living Labs; Pre-Pilot; Pilot. Aim: The aim of this paper is to describe the first four phases of the project, including the results of the usability study (phases 3–4). Design and methods: Co-creation followed the YOUSE Toolbox of Active and Assisted Living projects for user-centred design. Phases 1–4 of the study were conducted in parallel in Italy, Portugal, Romania, to integrate feedback from all sites. To assess the usability and the level of stress related to technology usage (phases 3 and 4), the System Usability Scale (SUS) and the Technostress (TS) were administered, respectively. Results: Two hundred and eighty-two participants (Italy n = 103; Portugal n = 86; Romania n = 93) were involved. Participants appreciated the solution, its services and the health self-monitoring opportunities. Feedback from phases 1 to 4 led wearables choice, interfaces design and coaching strategies. SUS scores showed a significant reduction during Living Lab and Pre-Pilot (p < 0.001); TS did not significantly change. Both scores differed between user groups and countries. Conclusions: This paper presents a reproducible and measurable co-creation approach that has been successfully applied to develop different digital health services for AHA and rehabilitation.